Doctors never cease from complaining about insurers’ bureaucracy. It’s one reason why they cannot stand the repeated Medicare “doc fixes” that have occurred at least once a year for over a decade: When Congress does not increase the physician fee schedule before the previous fix runs out, they fear that Medicare contractors will slow roll their claims, creating a big cash flow problem.
(That’s one reason why the lobbyists supporting today’s fiscally irresponsible “doc fix” waited until March 19 to let us know it was coming to the House of Representatives. Last year’s fix expired on March 31. Delaying until the last minute means the lobbyists can more easily drive politicians into a panicked herd and head them off a fiscal cliff.)
The cash flows can be observed by patients, who receive physicians’ invoices and insurers’ Explanation of Benefits (EOBs). One reader went to the doctor on July 31, 2014. As shown in the graphic below, the health plan processed the claim on August 25 and mailed it to the beneficiary on August 29.
There it sat, in a manila file folder at the beneficiary’s home, until a few days go. As the graphic below shows, the doctor’s office finalized the claim with the insurer on March 31, and printed a statement on April 2.
Read the entire column at NCPA's Health Policy Blog.
Research and commentary from a former senior executive in the U.S. Department of Health & Human Services
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