As medical providers, part of your job demands you work with insurance companies on a daily basis, and therefore, remain knowledgeable about said companies. We know that isn’t always easy—it can, in fact, be difficult to keep up with the varying nuts and bolts of each. So, we’re here to offer some help: we asked 10 medical billers about their experiences with health insurance companies, to shed light on some important considerations. And one of those questions was: Which insurance company is least likely to conduct an audit? The results are as follows:
While responses were all over the board, 20% of the medical billers said that Blue Cross Blue Shield is least likely to audit you. The remaining companies appear to be equally likely to audit, as 10% of responders voted Aetna, 10% voted Cigna, 10% voted Humana, 10% Magellan, 10% Tricare, and 10% UnitedHealthcare. Additionally, 10% said that all companies are just as likely to conduct an audit, while 10% were unsure.
A Brief Look at These Companies
Blue Cross Blue Shield (20% of votes)
Blue Cross Blue Shield “has led the healthcare industry by rising to the challenges that change brings, enabling new discoveries, and continuing to evolve,” according to its webpage. This particular insurance company prides itself on providing clients with “high-quality, affordable” coverage and doing so with experienced employees and through valuable partnerships. And according to 20% of surveyed medical billers, it is least likely to audit you.
Aetna (10% of votes)
Aetna was founded over 150 years ago and is dedicated to providing customers—whether they be individuals, employers, or health care practitioners—with great service and benefits. CEO and President Mark Bertolini says that the company’s foundation is built on strong values, which include simplicity, focus, and connection: they seek to make the health care process simpler, narrow in on the importance of health, and connect customers and employees effectively.
Cigna (10% of votes)
Cigna is a health insurance company, “dedicated to helping people improve their health, well-being, and sense of security,” according to a statement on their website. While the company got its start more than 200 years ago, they have since transformed into the company “we know today,” which prioritizes true partnership between its team and customers.
Humana (10% of votes)
Humana takes satisfaction in working with all kinds of consumers, from families to military members to self-employed individuals to seniors—regardless of specific needs, Humana has a plan to offer. In addition, Humana prides itself on holding its employees to certain standards and in doing so, improving the health and wellbeing of customers as well as the entire planet. Furthermore, the company has received multiple awards for their products, services, and practices.
Magellan Health (10% of votes)
Magellan is another company that received 10% of the votes, which strives every day to fulfill their key values: integrity, accountability, collaboration, and caring. They believe that doing so will aid them in, “leading humanity to healthy vibrant lives,” as stated on their website. Like Aetna, Magellan also prioritizes interconnectedness, as they work with behavioral, physical, pharmacy, and social needs, and see them as equally important.
TRICARE (10% of votes)
TRICARE, which was formerly called Civilian Health and Medical Program of the Uniformed Services, is dedicated to providing uniformed service members and their families all around the world with reliable healthcare. This is further detailed in their mission and vision, as they strive to, “enhance the Department of Defense and nation’s security by providing health support for the full range of military operations and” and to also sustain these individuals’ health.
UnitedHealthcare (10% of votes)
UnitedHealthcare offers insurance plans that benefit the needs of both individuals and employers; they also offer dental, vision, and other plans. And according to their website, they’re united by their “mission to help people live healthier lives and make the health system work better for everyone.”
Whether or not an insurance company conducts an audit should not make or break your involvement with them. Contrary to popular belief, the process is typically brief and sometimes even beneficial: it just might help you stay organized and, in turn, maintain your company’s ethical standards. Still, you might be pleased to know the results above, which signify those least likely to conduct an audit, according to 10 medical billers. That being said, whether or not a company conducts an audit should be one mere consideration. Remember: there are plenty of other factors to consider. And this is just a pitstop.