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Bringing Physicians and Insurance Providers on the Same Wave-length

November 06, 2011



While physicians and health insurance providers have been indispensable and integral to US healthcare industry, the trust with each other has not been all that convincing – physicians being apprehensive of growing rate of denial and delay of their patients’ health insurance claims, and health insurance carriers being suspicious of physicians’ integrity in medical billing. Consequently, there is growing concern of it being adversely impacting the quality of patient care altogether. Therefore, there needs to be conscientious effort to bring these entities on equal wavelength in the larger interest of the patient community.

Given the prevailing scenario, physicians as well as the insurance carriers need to shed their respective inhibitions, and promote mutual trust. Physicians, on their part, would do well to:

  • Show integrity in medical billing
    Physicians, rather than being unduly avaricious, would do well to bill for those services that warrant medically necessary intervention. Such honest practices will invariably be recognized by the insurance providers concerned, and be a major step towards earning the much needed esteem from the insurance carriers.
  • Be open to constructive feed-back from insurance carriers
    Physicians, rather than being overly critical of feed-back – during delay or denial – need to imbibe a progressive attitude that can ensure a fresh perspective at delayed or denied claims. Consequently, this will ensure an amicable environment for resolving issues related to claim submission and realization.

While physicians are at it, insurance providers too need to compliment with their own, in terms of:

  • Honoring honest medical claims:
    Contrary to some unscrupulous physician claims, the industry generally thrives on honest practices. Therefore, insurance carriers, rather than being excessively stringent, need to recognize honest billing practices while being vigilant against intentional misrepresentation.
  • Educating physicians on the efficacy of insurance authorization
    Rather than being just a judge, insurance carriers would do well to educate physicians on the necessity of availing Insurance Authorization, which endorses the entitlement of insurance benefits to the patient in question. Such, proactive advice, will not only save physicians from subsequent embarrassment, but also earn their respect, which could be crucial in being referral for prospective health insurance seekers.

But, given the prevailing chasm, and an excessively demanding health insurance environment post the recent radical health reforms, physicians as well as the health insurance carriers are unlikely to reach the desirable wavelength of mutual trust within the requisite timeframe. Therefore, it is high time that a catalyst stepped in to augment the process. Medicalbillersandcoders.com (www.medicalbillersandcoders.com), having been preferential medical billing partner for a majority physician practices across the whole of the US, should amply be capable of ensuring a seamless relationship between the physician community and the health insurance carriers.

Known for its ingenious way of Physician Credentialing – a prerequisite to win insurance carriers confidence, and insurance authorization – a prerequisite to establish the coverage of medical benefits, along with being a moderator of all the likely communication between the two entities can be crucial in diffusing the apprehensive environment. Therefore, it is no wonder then that Medicalbillersandcoders.com has been able to build rapport with a diverse portfolio of private carriers – United health, Wellpoint, Aetna, Humana, HCSC, Blue Cross Group, and Government sponsored Medicare and Medicaid.

 

Category : Practice Administration