What California HMOs’ Denial Rates Mean for Behavioral Health Provider Organizations

September 19, 2009 Recently published data on claims denial rates have become an element of the health care reform discussion. A recent analysis conducted by the California Nurses Association found denial rates varied greatly between California HMOs: Aetna – 6.5% PacifiCare – 39.6% Anthem Blue Cross (California’s largest for-profit health plan) – 28% Kaiser (California’s largest nonprofit plan) – 28% Cigna – 33% The study examined state government-collected data received from California HMOs by the California Department of Managed Care, from 2002 through June of 2009, and found that the five largest insurers (listed above) had rejected 31.2 . . .