Health Insurance Companies Ranked On Claims Resolution, Doctor Payment Efficiency

Health Insurance Companies Ranked On Claims Resolution, Doctor Payment Efficiency in Individual Health Insurance

If you’ve ever wondered how your health insurance company performs when it comes to claims and payments for doctors, a three-year old rating system can tell you.

Over 130 health insurance carriers have been rated and ranked by Athenahealth, Inc. — a company providing medical business management tools for doctors.

Each insurer is rated based on a number of different factors. The most important factors include how quickly an insurance company makes payments to doctors, how well they resolve claims, and how many claims they deny.

This year, the most efficient insurance company is Aetna, Inc.

Here are Aetna’s stats, according to Athenahealth — they take an average of 27 days to pay doctors for their services, resolve 96 percent of claims on the first try, and deny only 5.9 percent of claims, reported the Wall Street Journal.

The next best insurer was CIGNA — they pay doctors in an average 33 days, resolve 96 percent of claims, and deny 6.6 percent.

The worst performer wasn’t a private insurer, but the Medicaid program in New York state. They take an average of 137 days to pay doctors, resolve only 57 percent of claims, and deny 39 percent.

This is the third year of insurer ratings, wrote the WSJ article, with the goal of bringing more transparency in the health care and health insurance industry.

Whether these rankings and performance statistics are fully accurate is being disputed, but probably at least provides a general snapshot on how well an insurer operates.

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