GOVERNMENTHave a Medicare policy question? Carriers usually give wrong answersA GAO report finds that 96% of the time, answers to billing questions are incomplete, only partially correct or totally inaccurate.By Joel B. Finkelstein, AMNews staff. Sept. 6, 2004. Washington -- Medicare carrier call centers could become the last place physicians want to go to have their billing questions answered after a recent government report showed that the centers' already dismal accuracy rate has dropped over the past couple of years. Physicians, many of whom feel that federal officials constantly look over doctors' shoulders for any Medicare claims that hint of fraud or abuse, are unlikely to find solace in the Government Accountability Office's findings. For the study, the GAO posed four questions to Medicare carrier phone banks about how to bill the program properly. In the 300 test calls, customer service representatives gave correct and complete responses only 4% of the time, and more than half the time the answers were simply wrong. "While the Medicare call centers' inability to correctly answer physicians' questions is troubling, sadly it is not surprising," said J. James Rohack, MD, chair of the American Medical Association Board of Trustees. The report follows up on a survey conducted almost two years ago that found call centers answered questions correctly only about 15% of the time. "It's a well-known fact that they're often wrong," said Mary Jean Sage, a practice management consultant with Sage Associates in Arroyo Grande, Calif. The problem of wrong answers appears to be so persistent and pervasive that most physicians have given up on the call centers, some experts said. [...]Full text of AMNews content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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