What world have they been living in?
Have these people had their head buried in the sand or what?
In one of the first physician satisfaction surveys on insurers made public the doctors in the Houston area gave poor marks to six area health insurers and stated they have failed patients, employers and doctors on patient-care, payment and customer service issues.
The chairman of the society’s managed care committee said she was surprised how bad it was.
She went on to say “the survey shows insurance companies are failing patients, doctors and employers who pay for healthcare services by creating ways and resistance to hold onto their money.”
Again, what is surprising is that anyone who has worked as a physician or with a physician in private practice would make this statement publicly.
I am unsure how much louder physicians can voice their discontent with the current system and third party payers.
The release of this survey was just one of a number of efforts by physicians to turn up the heat on health insurers, which organized medicine claims are putting profits ahead of patient care.
Another example of turning up the heat is New York Attorney General Andrew Cuomo’s plans to file suit against UnitedHealth Group for allegedly gerrymandering reimbursement rates paid to physicians and other healthcare providers.
The Houston survey also showed the following:
**More than 65% of the doctors reported they have experienced difficulty getting their patients’ medical services approved.
**Some 69% have problems with prompt payment, and 64% say they are paid less than their contracted rate.
**On education, 58% say their patients do not understand benefits, co-payments, deductibles and limitations of their coverage.
**65% say their patients rarely understand preventive services and care-coordination services available to them.
The response from one of the insurers in the area said that although we had no advance notice of the survey, Blue Cross is very aware of physician dissatisfaction on the issues raised in the survey. Being aware does little to fix the problems.
There were 487 physicians who took the survey and it evaluated the plans in their area, which included Aetna, Cigna Corp., Humana, the Texas Blues, UniCare and UnitedHealthcare.
Doctors gave stories like a patient with macular degeneration turning into lost eyesight because the patient could not get treatment approved, and another patient died while waiting for his insurer to preauthorize a magnetic resonance angiography, a test that could have revealed the carotid artery dissection that triggered his stroke.
Doctors complained about a range of issues including delayed reimbursements, paying less than contracted rates, providing services without reimbursement, and time spent trying to preauthorize medical services.
None of these complaints are new and no one should be surprised just because suddenly a survey was published showing the details.
Offices have to hire additional staff just to handle insurance problems and the insurers continually hassle offices wanting to know why we are ordering medical services and prescriptions and want us to provide three peer-reviewed articles to prove what we want to do.
If that doesn’t convince you not to order the test or drug they say you have to then discuss it with their medical director.
The barriers that are placed by the insurers cause significant delays and denial of care and has been worsening.
Making the results of these type of surveys public is a new twist and it will help prevent the problems from being swept under the rug or kept private.
Efforts to manage these issues privately have failed and it took a legislative measure to mandate that insurers pay physicians in 45 days when a clean claim is filed.
As more and more payers launch Web sites to rate doctors, it is high time insurers are publicly rated and held accountable.
In one of the first physician satisfaction surveys on insurers made public the doctors in the Houston area gave poor marks to six area health insurers and stated they have failed patients, employers and doctors on patient-care, payment and customer service issues.
The chairman of the society’s managed care committee said she was surprised how bad it was.
She went on to say “the survey shows insurance companies are failing patients, doctors and employers who pay for healthcare services by creating ways and resistance to hold onto their money.”
Again, what is surprising is that anyone who has worked as a physician or with a physician in private practice would make this statement publicly.
I am unsure how much louder physicians can voice their discontent with the current system and third party payers.
The release of this survey was just one of a number of efforts by physicians to turn up the heat on health insurers, which organized medicine claims are putting profits ahead of patient care.
Another example of turning up the heat is New York Attorney General Andrew Cuomo’s plans to file suit against UnitedHealth Group for allegedly gerrymandering reimbursement rates paid to physicians and other healthcare providers.
The Houston survey also showed the following:
**More than 65% of the doctors reported they have experienced difficulty getting their patients’ medical services approved.
**Some 69% have problems with prompt payment, and 64% say they are paid less than their contracted rate.
**On education, 58% say their patients do not understand benefits, co-payments, deductibles and limitations of their coverage.
**65% say their patients rarely understand preventive services and care-coordination services available to them.
The response from one of the insurers in the area said that although we had no advance notice of the survey, Blue Cross is very aware of physician dissatisfaction on the issues raised in the survey. Being aware does little to fix the problems.
There were 487 physicians who took the survey and it evaluated the plans in their area, which included Aetna, Cigna Corp., Humana, the Texas Blues, UniCare and UnitedHealthcare.
Doctors gave stories like a patient with macular degeneration turning into lost eyesight because the patient could not get treatment approved, and another patient died while waiting for his insurer to preauthorize a magnetic resonance angiography, a test that could have revealed the carotid artery dissection that triggered his stroke.
Doctors complained about a range of issues including delayed reimbursements, paying less than contracted rates, providing services without reimbursement, and time spent trying to preauthorize medical services.
None of these complaints are new and no one should be surprised just because suddenly a survey was published showing the details.
Offices have to hire additional staff just to handle insurance problems and the insurers continually hassle offices wanting to know why we are ordering medical services and prescriptions and want us to provide three peer-reviewed articles to prove what we want to do.
If that doesn’t convince you not to order the test or drug they say you have to then discuss it with their medical director.
The barriers that are placed by the insurers cause significant delays and denial of care and has been worsening.
Making the results of these type of surveys public is a new twist and it will help prevent the problems from being swept under the rug or kept private.
Efforts to manage these issues privately have failed and it took a legislative measure to mandate that insurers pay physicians in 45 days when a clean claim is filed.
As more and more payers launch Web sites to rate doctors, it is high time insurers are publicly rated and held accountable.
Labels: healthcare, insurance, ratings, survey
posted by Anonymous at 5:50 AM
2 Comments:
I think most everyone could have guessed what the results of that survey would have shown. The problems are well known. What is the solution?
I think we should let every doctor do whatever he wants and charge whatever he would like and insurance companies should be forced to pay whatever the doctor says his/her services are worth. I am sure that would be good for health care and would reduce the overall cost of medical care in this country. Oh yes, I also think we should force schools to teach creationism on an equal footing with evolution, and the Ten Commandments (King James version, of course) should be displayed in every government office in the land.
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