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Medicare’s Refusal of Medical Claims Continues to Outpace Private Rate
...The following week, Health Care for America Now, a group supporting the Democrats’ health care reform bill, ran a television ad claiming that private health insurance companies: “Deny 1 out of 5 treatments prescribed by doctors.”

When fact-checked by PolitiFact.com, it turned out the statistic had been derived by the California Nurses Association, which broadened its definition of “denial” to include such administrative non-events as a claim having been sent to the wrong insurer. Such snafus occur behind the scenes, and the patient never knows about them because his/her claim is, in fact, subsequently paid by the correct insurer....

...According to the American Medical Association’s National Health Insurer Report Card for 2008, the government’s health plan, Medicare, denied medical claims at nearly double the average for private insurers: Medicare denied 6.85% of claims. The highest private insurance denier was Aetna @ 6.8%, followed by Anthem Blue Cross @ 3.44, with an average denial rate of medical claims by private insurers of 3.88%

In its 2009 National Health Insurer Report Card, the AMA reports that Medicare denied only 4% of claims—a big improvement, but outpaced better still by the private insurers. The prior year’s high private denier, Aetna, reduced denials to 1.81%—an astounding 75% improvement—with similar declines by all other private insurers, to average only 2.79%....