BUSINESSHMO hassles? Add them to the collection of complaintsGathering "hassle factor" data helps medical societies pinpoint the most common problems physicians are encountering with managed care companies.By Julie A. Jacob, amednews staff. Aug. 20, 2001. Using the philosophy that knowledge is power, more and more state medical societies are keeping detailed databases tracking the hassles and frustrations their members encounter with managed care plans. About two-thirds of state medical societies have "hassle log" programs in place, according to the AMA Private Sector Advocacy department. The programs give the medical societies concrete data on physician problems with the plans, which state societies can then use when meeting with representatives of managed care companies or state insurance departments. Although the programs vary from state to state, they usually work like this: Physicians fill out forms documenting the type of problem -- such as late claims payments, downcoded claims, excessive paperwork requirements -- and send them to their state medical society. The society then logs the information into a database that sorts and organizes the complaints by insurer, region and type of complaint. The knowledge gleaned from tracking the number and types of physician complaints is helping state societies work more effectively to resolve issues, or at the very least to alert state insurance departments about problems, say state society staff members. The Texas Medical Assn., for example, received about 5,000 complaint forms last year from physicians documenting their problems with denied or delayed payments, downcoded claims and administrative hassles, said Richard Johnson, the TMA's director of medical economics. The TMA uses the information in its database as the basis for discussions at its regular meetings with representatives of managed care companies, said Johnson.
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Copyright 2001 American Medical Association. All rights reserved.
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