Insurer Ratings Report 2011

How Doctors Get More From Insurers (Despite Anger and Frustration)

Physicians Rate Best and Worst Payers

Mark Crane

Disclosures

December 05, 2011

In This Article

Introduction

To say that physicians are frustrated with healthcare insurance payers is akin to saying that zebras are frustrated with how lions treat them.

More than 10,000 physicians across the nation participated in Medscape's Insurer Ratings Report 2011. Feelings of outrage, resignation, and powerlessness dominated the comments that we received.

In more than 4700 physician remarks, the vitriol jumped off the page about physicians' perceptions of unjustified denials of claims, needless preauthorization demands, and requests for documentation that seem designed to stall payment for as long as possible.

Many physicians told us they believe that insurers are intentionally difficult as a matter of business policy. Their theory: If the companies can wear physicians down with repeated denials and paperwork demands, a high percentage of doctors will give up trying to secure their deserved reimbursement.

The highlights of the survey include:

• 28% of physicians say a Blue plan (Blue Cross, Blue Shield) is their best insurer, followed by Aetna, United Healthcare, and Cigna.

• 14% of physicians say United Healthcare is the worst insurer, followed by Blue plans, Aetna, Cigna, and Humana.

• Three in 10 doctors say they don't know which insurer is their best payer.

• A majority of physicians say they don't know the allowed reimbursement amount for their highest-volume CPT code.

While many insurer tactics clearly evoke anger, some physicians may share the responsibility for problems in collecting proper reimbursement from health plans.

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