“Physician group practices are expressing dissatisfaction with the complexity and lack of information associated with insurance products sold on (Obamacare) exchanges,” Dr. Susan Turney, MGMA president and CEO, said in a news release. “The more administrative complexity introduced into the healthcare system, the less time and resources practices can devote to patient care.”
Verifying coverage for patients in exchange plans takes up to 20 minutes, compared with seconds for those in non-exchange plans, practices told the association. “We are going to have to hire additional staff just to manage the verification process,” one practice manager said.
Practices also have encountered severe network limitations. Almost half of respondents reported they have been unable to provide covered services to exchange patients because their practice was out of the patient's network. Twenty percent reported their practice was excluded from a narrow network that they wanted to participate in.
They also face problems in identifying in-network providers for referral of patients. “As primary-care providers, we are now faced with the extra burden of trying to find them care within their new narrow network,” a survey participant said. “Payer directories are woefully inaccurate and impossible to rely on.”
Almost 80% of the responding medical groups reported their practice is participating in exchange plans. About 56% said they had not seen any change in their patient population size, while 24% said they had seen a slight increase.
The administrative difficulties practices have faced with exchange plans has caused them to question whether they want to take on more exchange patients, said Allison Brennan, a senior MGMA adviser.
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