Physicians are likely to face another cut in Medicare reimbursements of 27% in 2012, in a scenario where doctors state that insurers regularly underpay or flat out deny, as a matter of course, legitimate health insurance claims worth billions of dollars each year.<\/p>\n
According to American Association for Justice (AAJ) the US insurance industry is in dire need of reform, with various insurance companies, doing everything to maximize their pro\ufb01ts and rid themselves of claims. Physicians have suffered from unfair reimbursements due to a conflict-ridden system that has been owned, operated, and manipulated by the health insurance industry.<\/p>\n
In an unfair reimbursements case filed against healthcare insurance carrier UnitedHealth Group, Ingenix a research firm owned by UnitedHealth was under investigation. The suit alleged a conspiracy to lower health insurance reimbursements when patients see a doctor outside their provider network. Companies such as Ingenix use technology to reduce the money insurance companies\u2019 pay out to doctors. UnitedHealth Group reached a settlement with the New York Attorney General’s office and agreed to pay $50 million to reform the way it determines these\u00a0reimbursements.<\/p>\n
The AMA analyzed 5 million claims records from Medicare and 7 national health insurers, which found that \u201cinefficient and unpredictable\u201d claims-review procedures by insurers cost the health care system $210 billion annually, diverting roughly 14% of physician resources.<\/p>\n