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Physician & Group Practice Ratings of Health Insurance Plans

Primary Listings

AMA Rates Health Insurance Plans' Claims Processing 2010

The American Medical Association (AMA) 2010 National Health Insurer Report Card rates how well Aetna, Anthem BCBS, CIGNA, Coventry, Health Care Services Corporation (HCSC, which owns Blue Cross Blue Shield plans in IL, NM, OK and TX), Humana and United Healthcare (UHC) handle physician claims. HCSC plans adhered to the contracted rate 94% of the time, but Anthem BCBS was at the low end at 78%. See Metric 5 and about 20 other measures. Denials (Metric 11) ranged from 0.7% to 4.5%. No composite scores or conclusions. Geared to doctors, payers and industry insiders rather than consumers. Data from Feb-Mar 2010, pub. June 2010

MGMA Members Rate Health Insurance Plans 2009

Find out how members of the Medical Group Management Association rate Medicare Part B, Aetna, CIGNA, Coventry, Humana, Anthem and UnitedHealthcare health insurance companies (payers). On a scale of 1 (low) to 5 (high), the best can only muster a 3.6 rating. These scores indicate how easy a health plan is to do business with. Pub. Oct. 2009

Other Helpful Listings

Illinois HMO Complaints 2008 by Consumers & Physicians (pdf)

Complaint record from 2008, supplied by the Illinois Dept. of Insurance. Note: you will find the Blue Cross Blue Shield complaints under Health Care Service Corporation. Other HMOs include Aetna, Cigna (IL and St. Louis), Group Health, Health Alliance, HMO Missouri, Humana, Medical Associates, Mercy, NevadaCare, Personal Care Insurance, Unicare, Union, United Healthcare (IL, Midwest and Rivervalley). Both consumer and provider complaints about the HMO are counted, and classified by type (such as claims or denial of care/ treatment. Two pages, July 2009

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