Are you a medical provider looking for some valuable information on health insurance companies? Look no further. We recognize your need to stay informed on the insurers you work with on a day-to-day basis. And we want to help you do so. To gather quality information about these companies we asked 10 medical billers a series of survey questions, regarding their experience with said insurers. One of those questions was: Which insurance company is most likely to ask for money back?
The thought of an insurance company taking money back is a scary one, but the good news is that it’s exceedingly uncommon. Our question specifically asked which companies are most likely to take money back, but it didn’t ask how often it happens—which means it may be extremely rare even for the companies voted “most likely” to do so. Additionally, some insurance companies are quick to pay claims, which means they might overpay and then ask for that money back later. So, even though they ask for money back more often than other companies, it could be that the other company would have never paid the claim in the first place. Keep these considerations in mind as you review the following results:
Responses varied greatly, but Blue Cross Blue Shield received the highest percentage, or 30%, of the votes. There was then a tie for second place, between Aetna and United Healthcare, each receiving 20% of the votes. And the remaining votes were split between three different companies, Cigna, Optum, and S&S (or Piedmont Community Health Plan): 10% said Cigna was most likely to take money back, another 10% said Optum was most likely to take money back, and the final 10% said Piedmont Community Health Plan was most likely to take money back.
A Quick Glance at These Companies
Need a quick reminder on what these companies are all about? Here are some additional details about the insurers and their cultures:
Blue Cross Blue Shield (30% of votes)
Blue Cross Blue Shield was launched in 1929 and has worked to provide reliable healthcare to people all across the nation ever since. They also work closely with healthcare providers, as over 96% of hospitals and 93% of doctors contract with this insurer. Furthermore, Blue Cross Blue Shield’s mission is to allow its clients to live without fear or worry, due to the quality and affordable healthcare they provide.
Aetna (20% of votes)
Aetna was founded over 150 years ago and has since committed its time and effort to, “providing individuals, employers, health care professionals, producers, and others with innovative benefits, products, and services.” Aetna strives to make healthcare simpler, as well as more accessible and convenient for all of its clients. Additionally, the team members at Aetna truly care about the customers and prioritize helping them in any way that they can.
United Healthcare (20% of votes)
United Healthcare serves millions of people, with the goal of helping each individual live a healthier and happier life. This company recognizes the incredible opportunity to improve their customers’ lives and strives to do so in any way that they can. Each day, they work to better their system, one that is, “connected, aligned, and more affordable for all involved.”
Cigna (10% of votes)
Cigna, another widely used and trusted company, provides healthcare to clients in 30 different countries and jurisdictions. Their ultimate goal is to provide customers with amazing service that is both proactive and personal, and they are dedicated to creating true partnerships. Furthermore, the Cigna team works to help these clients live more secure lives.
Optum (10% of votes)
Optum is another company which sets out to improve the health care system and help people live healthier lives. They are “tackling the biggest challenges in health care by partnering across the entire system,” and in turn, “are transforming health care for a better future,” for their customers. The Optum team is committed to this mission and passionate about transforming health care for the better.
Piedmont Community Health Plan (10% of votes)
Piedmont Community Health Plan, a smaller scale company, is Central Virginia’s healthcare organization, dedicated to providing members with access to quality and efficient medical care. PCHP is part of the Centra Health System and operates under the principle that local healthcare providers, patients, and employers work closely together.
Overpayments can occur for a multitude of reasons: an insurer may make a simple mistake and pay more than the contracted amount for a given service, or a healthcare provider may be paid for a service that isn’t covered by a patient’s plan. In either case, or in those alike, an insurance company is likely to ask for money back in attempt to correct their mistake. Therefore, you should not base your partnership with any of the above companies based on whether or not they’re more likely to ask for money back. You should, however, include these survey results in the information you review and consider.