I bet if you limited pre-auths to the truly, truly necessary, you'd increase doc satisfaction by 10-fold. Just imagine a day without having to call an insurance company to argue for standard of care for your patient with an AI-powered bot.
Mark Edelstein - 3 months ago
When two entities compete for the same $1-one is going to be much more highly dissatisfied than the other. As a rule, insurers control the reimbursement schedules and so all physicians I speak to complain about the commercial publicly traded commercial carriers. Complaints about denials. ,pre authorizations and short pays. In general , physicians do not complain about Medicare reimbursement. They do complain about Medicare advantage however and of course the underfunding of Medicaid.
That said , the rack rates physicians attempt to charge when dealing with uninsured patients are stupid crazy. Always negotiate.
Ivan Durbak - 3 months ago
Insurers are main problem
JT - 3 months ago
IMHO, EHRs evolved out of a need by physicians to provide robust documentation to support the diagnostic codes they were submitting to insurers to simply get paid for the services they provide to patients. To be fair, there were some providers who were gaming the FFS system to line their pockets. There were others who didn’t properly document their work but expected to get paid (‘if It wasn’t Documented, It didn’t happen’). Physician Billing Systems gave birth to EHRs. The early systems were ugly and undoubtedly led to physician dissatisfaction. Physicians need to own their part in this, but so do vendors and insurers.
Just an IT Person - 3 months ago
The EHRs are usually fine until their employers start adding required fields and forms to satisfy insurance companies. Ultimately the problem is burdensome documentation requirements driven by payers that will use any excuse to avoid paying! But it’s easier to blame the software.
I bet if you limited pre-auths to the truly, truly necessary, you'd increase doc satisfaction by 10-fold. Just imagine a day without having to call an insurance company to argue for standard of care for your patient with an AI-powered bot.
When two entities compete for the same $1-one is going to be much more highly dissatisfied than the other. As a rule, insurers control the reimbursement schedules and so all physicians I speak to complain about the commercial publicly traded commercial carriers. Complaints about denials. ,pre authorizations and short pays. In general , physicians do not complain about Medicare reimbursement. They do complain about Medicare advantage however and of course the underfunding of Medicaid.
That said , the rack rates physicians attempt to charge when dealing with uninsured patients are stupid crazy. Always negotiate.
Insurers are main problem
IMHO, EHRs evolved out of a need by physicians to provide robust documentation to support the diagnostic codes they were submitting to insurers to simply get paid for the services they provide to patients. To be fair, there were some providers who were gaming the FFS system to line their pockets. There were others who didn’t properly document their work but expected to get paid (‘if It wasn’t Documented, It didn’t happen’). Physician Billing Systems gave birth to EHRs. The early systems were ugly and undoubtedly led to physician dissatisfaction. Physicians need to own their part in this, but so do vendors and insurers.
The EHRs are usually fine until their employers start adding required fields and forms to satisfy insurance companies. Ultimately the problem is burdensome documentation requirements driven by payers that will use any excuse to avoid paying! But it’s easier to blame the software.
toss up between EHRs and insur co. needs