#1 Physician Complaint About Payers: Claims Denials

In a new survey by Medscape, physicians identified denial of claims as the worst experience they have with insurance companies.

According to the survey's results, published in the "Insurer Ratings Report 2014," claims denials were the most frequently as well as the most intensively described negative experience.

Medscape also asked physicians to rate payers on their frequency of denials on a scale of 1 (frequent denials) to 5 (infrequent denials).

Out of 11 insurance companies, Medicare came in highest (fewest number of denials), followed by Blue Plans and Aetna. Humana took the lowest spot (highest number of denials), followed by Oxford Health Plans and HealthNet.

However, no insurer performed particularly well in the eyes of physicians. Medicare came in at 3.2, Blue Plans at 3.1, with all other insurers coming in lower.

More than 6,300 physicians across 25 specialties took part in the online survey from July 9 through September 21, 2014.

Claim denials create significant challenges for providers. Claims follow up is a time-consuming, costly and often unsuccessful process. At PGM Billing, we see claims denied by payers for myriad reasons that are unclear at best, wrong at worst.

Our more than 30 years experience as a leading provider of medical billing services allow us to work fast and effectively with insurance companies to address denied claims. This ensures our clients are paid what they rightfully earn. Contact us to learn what PGM's medical billing service can do to help you address the increasingly challenging problem of wrongful denial of claims.


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