Slow Pay, Low Pay, No Pay in the Times

For years — since the rise of so-called "managed care" — physicians have complained that the for-profit health plans make their money through a process of "deny or delay." The plans deny coverage if they can … otherwise they put off payment for physicians services for as long as they can.

Today's New York Times reports on an about-to-be-released survey documenting the insurance companies' tactics. The title of the article is "The Check is Not in the Mail." How true.

Read the Times article.

"The survey, an analysis of more than five million line items from health insurance claims submitted in the last three months of 2005, sheds light on the challenges that doctors and their patients face in getting their bills paid," writes Milt Freudenheim, the Times' excellent health care policy reporter.

"The data may also provide the glimmer of an answer to a seeming conundrum: How is it, as the nation staggers under growing health care costs, that the commercial insurers responsible for paying much of the bill tend to be highly profitable and have stocks that are performing well? Tight-fisted approaches to paying bills may be part of the answer."

Here in the Lone Star State, the Texas Medical Association has been documenting that "conundrum" for years.

Here's what we report in TMA's Healthy Vision 2010:

Despite the passage of prompt payment laws in 1999, 2001, and 2003, Texas physicians continue to struggle to get paid even deeply discounted fees for patient care. More than two-thirds of Texas physicians report slow payment and related cash-flow problems due to third-party payer policies. Nearly half of those doctors have had to draw on personal funds, or secure loans or lines of credit to cover practice expenses.

Our Healthy Vision solution calls on Texas to make sure we spend our precious health care dollars on health care … not elsewhere. Commercial health plans must stop shortchanging the employers, employees, and taxpayers who purchase their products – as well as the doctors and hospitals who provide critical professional services.

Read more about it on the TMA Web site.

Published in: on May 25, 2006 at 5:56 pm  Leave a Comment  

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