Doctors' Survey: Insurance companies impede patient care
December 5, 2007
Health insurance companies often block needed patient care through delays in processing claims and intervention by unqualified personnel, according to a first-ever survey of Houston-area physicians.
In the Harris County Medical Society's "Payor Survey," 487 local doctors rated the six largest insurance companies in Harris County on patient care, payment and customer service.
The non-scientific online survey, conducted by the Healthcare Administration Program at the University of Houston at Clear Lake, was sent to 5,700 area physicians. Roughly 10 percent responded.
Those that did gave cellar-level ratings to all six of the major health insurance companies operating in the area - Aetna, Blue Cross Blue Shield of Texas, Cigna, Humana, United Healthcare and Unicare.
Officials of the insurance companies were not immediately available for comment, or said they were preparing responses.
Greg Bernica, CEO of the Harris County Medical Society, said the group had hoped to rank insurers from best to worst. Instead, the companies all scored so low there was not enough statistical difference to do an actual ranking.
"They all came in last," he said.
Society President Dr. Michael Kelly [TMA member] said the group isn't looking to start a war with insurance companies but a dialogue about how to better serve patients and the big businesses that pay insurance premiums for their workers.
"Our goal was to recognize good performance and identify problems. The results were dismal at best," Kelly said.
The survey found:
• 70 percent of physicians responding said insurance companies had denied claims for medically necessary procedures.
• 66 percent said they had trouble getting insurance company preauthorization for scans and other imaging.
• 83 percent said the red-tape and delayed payment involving insurance companies required them to fill at least one, and often two or three, administrative positions per doctor to deal with filing and billing issues.