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Provider Reimbursement Policies

Editor’s note: While we have heard for years about providers issues with commercial carriers, does a less than 4.0 rating surprise you and communicate a new message about government plan reimbursements to providers?

Medicare Part B receives high ratings for disclosure of payment policies
The Medical Group Management Association (MGMA) conducted its second annual poll to determine group practice professionals’ attitudes about payer interactions. This year’s questionnaire focused on seven large payers; Aetna, Anthem, CIGNA, Coventry, Humana, Medicare Part B and United Healthcare. More than 1,700 practice professionals participated in the poll. Results reflect the members’ perceptions of the payer environment in areas of payer communications, provider credentialing, contracting, payment policies, system transparency and overall satisfaction.
How satisfied are you that the payer fully discloses it’s payment policies?
Ranking Payer Rating Average
1 Medicare Part B 3.86
2 Aetna 2.91
3 CIGNA 2.90
4 Humana 2.80
5 Coventry 2.79
6 Anthem 2.77
7 United Healthcare 2.61

Based upon a 5 point scale where 1= Completely dissatisfied, 2=Moderately dissatisfied, 3=Neutral, 4=Moderately satisfied, and 5=Completely satisfied.

Source: The Medical Group Management Association (MGMA), Practice Perspectives on Payer Performance, 2009.


October 22, 2009 - Posted by | Federal Government, Reimbursement | ,

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