The Day: Insurance errors, premiums dropping

“The overall rate of inaccurate [insurance] claims payments increased since last year among leading commercial health insurers, according to American Medical Association’s (AMA) fourth annual National Health Insurer Report Card. Claims-processing errors by health insurance companies waste billions of dollars and frustrate patients and physicians.” The AMA is not a big fan of insurers, but it’s worth looking at their results; for example, they say, “Physicians received no payment at all from commercial health insurers on nearly 23 percent of claims they submitted.”

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Some health plan providers seem to be retrenching on their premium increases, a welcome note.

Just announced is a new low-cost insurance plan called “AffordaBlue” from Blue Cross of Northeastern Pennsylvania, under which customers can choose among providers in three tiers, according to The Times-Tribune from Scranton, Pa. “Providers in Tier 1 offer care at a lower cost to Blue Cross NEPA … and the savings are passed along to the customer through lower deductibles and lower co-pays than providers in Tier 2 and Tier 3. ‘It is a straight recognition of cost differences where people get their care,’ [Blue Cross NEPA Senior Vice President Paul] Holdren said.  ‘Costs vary amongst health care providers across the region.’

“He estimated that the plan could save employers up to 20 percent on premiums, depending on how many of the people insured under a group’s plan choose Tier 1 providers.”

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California Blue Shield pledges $180 million in rebates: The money will go to customer credits, public health and Accountable Care Organizations. The insurer will limit its annual income, but doesn’t guarantee it won’t raise rates again.  AMedNews, published by the American Medical Association.

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Overuse of medical procedures is an increasing problem, one that’s easy to see with the new release of government-collected health data.

“Long after questions were first raised about the overuse of powerful CT scans, hundreds of hospitals across the country needlessly exposed patients to radiation by scanning their chests twice on the same day, according to federal records and interviews with researchers. ” Walt Bogdanich and Jo Craven McGinty in The New York Times.