Doctors Surveyed About Best and Worst in Insurers

While doctors can cite positives and negatives in most of their relationships with insurance companies, there are obviously certain factors that rank higher in importance. The authors of Medscape’s Insurer Ratings Report 2011 asked physicians what were the most important factors that made a payor ideal to work with.

The survey was sent to 307,000 physicians in the United States, with 10,214 of them being returned with responses. The most important factor, coming from 54 percent of physicians, was the level of payment from insurers. (It’s hard to imagine a more important factor than making sure doctors are compensated fully for their services.)

Other important factors from responding physicians included that the company is easy to do business with (15 percent) and the frequency of payment denials (13 percent). In regards to the latter, doctors said they think plans make unjustifiable denials and have unnecessary preauthorization demands.

According to Medscape in their written survey, the emotions ran high in regards to the bureaucratic hoops doctors have to jump through with their claims:

“Feelings of outrage, resignation, and powerlessness dominated the comments that we received. In more than 4,700 physician remarks, the vitriol jumped off the page about physicians’ perceptions of unjustified denials of claims, needless preauthorization demands, and requests for documentation that seem designed to stall payment for as long as possible.”

The overall – and overwhelming – “winner” was Blues Plans with 29 percent of physicians calling them their best payor. Aetna came in a distant second at 10 percent.

Here is a breakdown of the top payors voted upon by physicians in various medical specialties. Since Blues Plans swept the competition, the runners up are the only ones who vary:

Anesthesiology - Blues Plans (21 percent), United Healthcare (12 percent)

Gastroenterology - Blues Plans (31 percent), Aetna (15 percent)

General surgery - Blues Plans (32 percent), Aetna (11 percent)

Neurology - Blues Plans (33 percent), Aetna (14 percent)

Ophthalmology - Blues Plans (28 percent), Aetna (10 percent)

Orthopedics – Blues Plans (28 percent), Aetna (8 percent)

Plastic surgery and aesthetic medicine – Blues Plans (29 percent), Aetna (11 percent)

Radiology - Blues Plans (28 percent), Aetna (7 percent)

Rheumatology - Blues Plans (25 percent), Cigna (14 percent)

Surgery - Blues Plans (28 percent), United Healthcare (10 percent)

Urology - Blues Plans (23 percent), Aetna (13 percent)

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Guide: Accountable Care Organizations

Click here to download our Guide: "How Independent Practices Can Succeed in a Healthcare Industry Shaped by ACO Programs". If you would like more information you can Request a consultation.

Practice Management

  • Anesthesia Billing
  • Full-service medical billing
  • Patient account management
  • Encounter form design
  • Patient balance collections
  • Learn More

MBA In The News

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