@warpur I work as an Insurance Billing Specialist for a medical provider on the Eastern Seaboard. In October, the Practice Manager asked me to compile a list of the best/worst insurance companies based on how fast claims are processed, how often they are denied, etc. The purpose was to determine which insurances we would continue to take/stop taking for next year. I created a rubric and assigned grades for 3 categories- Ease of Authorization, Amount of time it takes to pay on a claim, and the likelihood of "false denials" (denied claims which should not have been denied- ex. denying a claim for no prior authorization when we did have authorization and the authorization number was in the correct box on the claim form). Out of all insurances we accept, Anthem was the only company get a grade of less than 20/100 for all three categories. Some highlights of the report were:
Anthem denied a claim for no prior authorization when their website specifically states that no prior authorization is required for that specific procedure.
Athem Claims Supervisor who openly admitted they do not read the medical documentation which we submit to support medical necessity of procedures.
Multiple Anthem reps (including several supervisors) insisting April has 31 days.
Unfortunately, I also found out that this is not unique to my State, Many Insurancde Billers in other States have reported their own Anthem horror stories. Needless to say, our practice will not be accepting Anthem in 2024. We sent out a notice to our patients with a list of which insurances we are taking/dropping- every single one of our patients who had Anthem in 2023 (not an insignificant percentage) let us know that they want to remain with our practice and therefore have obtained insurance from another company. Our employee health plan has also stopped using Anthem and has gone with a different company.