Research Firm Tactics Result in Lower Health Insurance Reimbursements for Millions of Policyholders

Research Firm Tactics Result in Lower Health Insurance Reimbursements for Millions of Policyholders in Individual Health Insurance

As a consumer, you trust your health insurance company to charge you fair rates for your coverage and your health care costs.

As a health insurance company, you trust your claims research company to provide correct data on how much you need to reimburse your policyholders for their health insurance claims.

Unfortunately for consumers and the health insurance companies, the wheels on the bus fell off on both accounts.

Ingenix, a health insurance research firm who provides claims data for several of the largest insurers in the country, has been accused of manipulating data so insurance companies end up paying much less then they should in reimbursements to their policyholders.

New York Attorney General Andrew Cuomo, who is no stranger to scrutinizing health insurance companies’ business practices, is leading the investigation.

As result of the data manipulation by Ingenix, reads a report by Cuomo, “Americans have been under-reimbursed to the tune of at least hundreds of millions of dollars,” reported the MSNBC.

“This was unethical, and it robbed vulnerable patients of insurance reimbursements they deserved,” said Cuomo.

Insurers themselves are being implicated in these tactics, but it’s hard to believe they’d knowingly participate in such an egregious act.

It’s a double-whammy for consumers and insurers. Ouch and ouch.

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