48 statistics on claim denials by payer

Here are 48 statistics on the percentage of claim lines denied for reasons other than a claim edit between 2008 and 2013 by specific payer, according to the American Medical Association.

Aetna

•    2008: 6.8 percent
•    2009: 1.81 percent
•    2010: 2.57 percent
•    2011: 1.38 percent
•    2012: 4 percent
•    2013:  1.5 percent

Anthem

•    2008: 4.62 percent
•    2009: 4.34 percent
•    2010: 4.5 percent
•    2011: 3.62 percent
•    2012: 5.07 percent
•    2013: 2.64 percent

Cigna

•    2008: 3.44 percent
•    2009: 2.56 percent
•    2010: 0.67 percent
•    2011: 0.68 percent
•    2012: 1.39 percent
•    2013: 0.54 percent

Health Care Service Corporation

•    2010: 2.67 percent
•    2011: 1.59 percent
•    2012: 3.06 percent
•    2013: 1.7 percent

Humana

•    2008: 2.9 percent
•    2009: 2.03 percent
•    2010: 2.18 percent
•    2011: 2.33 percent
•    2012: 1.97 percent
•    2013: 1.97 percent

Regence

•    2011: 1.36 percent
•    2012: 1.38 percent
•    2013: 1.18 percent

UnitedHealthcare

•    2008: 2.68 percent
•    2009: 2.02 percent
•    2010: 2.21 percent
•    2011: 1.05 percent
•    2012: 1.71 percent
•    2013: 1.18 percent

Medicare

•    2008: 6.85 percent
•    2009: 4 percent
•    2010: 3.82 percent
•    2011: 2.73 percent
•    2012: 3.78 percent
•    2013: 4.92 percent

More articles on coding and billing:
3 tips to rejuvenate ASC, physician practice revenue cycle
CMS: 3 New ICD-10 testing weeks
Are physicians fueling the price transparency trend?

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast