Healthcare reimbursement in the U.S. is frighteningly complex. We have federal payers, like Medicare; state/federal payers, like Medicaid; private, for-profit insurance companies, like Aetna; private, not for profit insurers, like many local Blue Cross Blue Shield networks. Oh yes, and we have private insurance companies managing reimbursement for many Medicare and Medicaid recipients.
This complexity comes with costs. Doctors and hospitals need to hire armies of people to process bills for all those different payers. By one estimate, in fact, physician offices spend 30 billion dollars a year on billing-related costs.
A recent study shows which payers are most likely to reject the bills submitted to them by physicians’ offices. The winner, in case you haven’t guessed it already, is Medicaid, regardless of whether the program is run by the government or private insurers.
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