| With the cost of delivering quality healthcare on | | | | the consistency with which these "Insurance |
| the rise, insurance companies continue to add to | | | | Company Supervisors" seem to have more |
| the problems facing physicians nationwide. Many | | | | detailed information available to them. In the end, |
| people believe doctors spend the majority of their | | | | it often takes more than one insurance company |
| time on golf courses while earning millions of | | | | representative and 45 minutes of time to receive |
| dollars. That may have been true in the past, but | | | | relevant information pertaining to just one |
| today there are formidable obstacles preventing | | | | insurance claim. |
| those that provide care from collecting their fees. | | | | With this being the case, one can see how the |
| These days many physicians are forced to | | | | term "wasteful healthcare spending" is so |
| write-off a large portion of revenue due to the | | | | common today. It seems as though the insurance |
| unreasonable practices of insurance carriers. | | | | companies are wasting time and money every |
| Insurance companies employ teams of | | | | day. Insurance companies profit billions of dollars |
| representatives responsible charged with the | | | | each year while making it extremely difficult for |
| receipt, processing, and servicing of insurance | | | | healthcare providers to receive reimbursement |
| claims. When healthcare providers submit | | | | for the services they perform. Even after |
| insurance claims, they are forced to follow-up | | | | healthcare providers verify coverage and obtain |
| vigorously in order to ensure that they receive | | | | prior authorization, insurance companies still delay |
| reimbursement. The process of submitting and | | | | payments and deny claims. |
| following up on claims is marred with holes and | | | | A recent report from PriceWaterhouseCoopers |
| inconsistencies making it difficult to communicate | | | | states that "inefficient claims processing" is the |
| with insurance carrier representatives. After | | | | second largest are of wasteful healthcare |
| navigating through a maze of automated | | | | spending, costing as much as $210 billion annually. |
| responses, healthcare providers and their billing | | | | The New England Journal of Medicine reports that |
| representatives are lucky to actually reach a live | | | | billing and overhead expenses consume as much |
| person. Once reaching a representative, all the | | | | as 43% of a physicians annual revenue. With |
| information previously submitted must then be | | | | statistics that these, it's no wonder the cost of |
| re-verified as if none of the previous entries were | | | | healthcare is spiraling out of control. Insurance |
| recognized. | | | | companies are profiting while individuals can hardly |
| As if the process had not been time consuming | | | | afford coverage, and helathcare providers find it |
| and difficult enough, healthcare professionals | | | | hard to turn a profit. Surely something is wrong. |
| usually realize that the person on the other side | | | | Although healthcare professionals are focused on |
| of the line only has basic information available to | | | | reducing costs and expanding coverage, they |
| them. What's worse is that they usually expect | | | | cannot do it alone. If we are to be successful |
| providers to simply accept the lack of information | | | | controlling the rising costs associated with |
| available and move on. In most cases, providers | | | | healthcare, insurance companies and government |
| and their staff must demand the help of a | | | | regulators must commit to change. Only through |
| supervisor just to receive any sort of reasonable | | | | a concentrated, coordinated effort will we achieve |
| insight in to the matter at hand. What's funny is | | | | affordable healthcare. |