Exchange plans give doc practices headaches

By July 9, 2014 January 3rd, 2020 Obamacare

Physician practices around the country say they are facing administrative hassles dealing with health plans on the insurance exchanges, according to a survey by the Medical Group Management Association.

But they also say the payment rates they are getting from exchange plans are higher than anticipated and are equal to rates paid by non-exchange plans and Medicare.

Nearly 60% of respondents said it is harder to verify patient coverage, obtain cost-sharing information and get information about in-network providers for exchange plans compared with non-exchange plans.

Physician group practices are expressing dissatisfaction with the complexity and lack of information associated with insurance products sold on Obamacare exchanges. The more administrative complexity introduced into the healthcare system the less time and resources practices can devote to patient care.

Some practices have also encountered severe network limitations. Almost half of respondents reported they have been unable to provide covered services to exchange patients because their practice was out of the patient’s network. Twenty percent reported their practice was excluded from a narrow network that they wanted to participate in.

They also face problems in identifying in-network providers for referral of patients.

One way Steinlage insurance can help ease these headaches is by helping the patient find the appropriate insurance plan that is both within the patient’s budget and accepted by the doctor. This keeps the patient’s costs at a minimum and promotes the doctor’s practice.

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