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out-of-network Archives - Steinlage Insurance Agency

Exchange plans give doc practices headaches

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Physician practices around the country say they are facing administrative hassles dealing with health plans on the insurance exchanges, according to a survey by the Medical Group Management Association. But they also say the payment rates they are getting from exchange plans are higher than anticipated and are equal to rates paid by non-exchange plans and Medicare. Nearly 60% of respondents said it is harder to verify patient coverage, obtain cost-sharing information and get information about in-network providers for exchange plans compared with non-exchange plans. Physician group practices are expressing dissatisfaction with the complexity and lack of information associated with insurance products sold on Obamacare exchanges. The more administrative complexity introduced into the healthcare system the less time and resources practices can devote to patient care. Some practices have also encountered severe network limitations. Almost half of respondents reported they have been unable to provide covered services to exchange patients…

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