Doctors’ Offices Get Put On Hold Trying to Find Out Who’s Insured

Filling out the forms is part of the ritual of going to the doctor. But with the Affordable Care Act, it's more complicated.

hide captionFilling out the forms is part of the ritual of going to the doctor. But with the Affordable Care Act, it’s more complicated.


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Sheila Lawless manages a small rheumatology practice in Wichita Falls, Texas, about two hours outside of Dallas. She makes sure everything in the office runs smoothly – scheduling patients, collecting payments, keeping the lights on. Recently she added another duty — incorporating the trickle of patients with insurance plans purchased on the new Affordable Care Act exchanges.

Open enrollment doesn’t end until March 31, but people who have already bought Obamacare plans are beginning to use them. “We had a smattering in January—maybe once a week. But I think we’re averaging two to three a day now,” says Lawless.

That doesn’t sound like many new customers, but it’s presented a major challenge: Each exchange patient has required the practice to spend an hour or more on the phone with the insurance company. “We’ve been on hold for an hour, an hour and 20, an hour and 45, been disconnected, have to call back again and repeat the process,” she explains. Those sorts of hold times add up fast.

In the past, offices have been able to make sure patients are insured quickly by using online verification systems run by the insurance companies. But for exchange patients, offices also have to call to make sure the patient has paid the premium. If it isn’t paid, the insurance company can refuse to pay the doctor for the visit, or recoup payments already made.

That’s because of a provision of the law that gives exchange patients

Article source: http://www.npr.org/blogs/health/2014/02/25/282115303/doctors-offices-get-put-on-hold-trying-to-find-out-whos-insured?ft=1&f=131849999

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