Well first we had Blue Cross with errors and now Aetna, so perhaps their own algorithms are getting to complicated for internal use too? This again makes another good statement for “certifying payer algorithms” just like we do with EHR systems.
Rules on EHR Certification Should Take Back Seat to Certifying Insurance Algorithms At Present – We Need This First
ALGORITHMS – INFLUENCE OR MAKE ABOUT 99% OF ALL THE DECISIONS HAPPENING TODAY – WE NEED ALGORITHMIC CENTRIC LAWS! Without these, how do we create audit tables that can not only audit health insurance and throw in the Federal Reserve as well.
Even the new government website to help consumers with selecting health insurance is getting a challenge as they can’t provide prices due to the complexity of the algorithms and in October they said at best there would be “estimates” of the costs to help consumers.
HealthCare.gov Portal Set to Launch July 1, 2010 To Help Consumers Research Policies – Insurer Proprietary Algorithms Will Not Allow for Pricing Information to be Included
Aetna Inc. withdrew its request to raise prices for individual policyholders in California by an average of 19% after discovering a flaw in its rate filing with state regulators, according to the California Department of Insurance.
California Insurance Commissioner Steve Poizner, a Republican candidate for governor, on Thursday said Aetna's withdrawal was voluntary. The errors include incorrectly calculating the annual cost of monthly premiums and incorrectly compounding the increases year over year, a spokesman for the department said.
The increase, filed in March and scheduled to go into effect July 1, would have hit 65,000 policyholders. A spokesman for Mr. Poizner said it was too early to say what impact the miscalculations had on the proposed percentage increase. The request followed a 17% average increase last year.