WASHINGTON BUREAU — Officials at the U.S. Government Accountability Office (GAO) have found wide variations in health insurance application denial rates.
The average application denial rate was 19%, but the denial rate varied significantly from carrier to carrier, GAO officials say in a new report.
About one quarter of the insurers studied had application denial rates from 0% to 15%, and another quarter had application denial rates of 40% or more.
The GAO officials came up with the application denial statistics using 2010 data collected from 459 individual market insurers by the U.S. Department of Health and Human Services (HHS).
GAO also analyzed data from 6 states that have their own programs for collecting application denial data.
In Maryland, for example, application denial rates ranged from a low of about 6% to a high over 30% in each of 3 years of data studied.
Claim denial rates also varied widely, both from carrier to carrier and from state to state, officials say. Officials found that aggregate claim denial rates range from 11% to 24% in the 3 states that collect claim denial data.
The researchers analyzed independent claim review data from 6 states and