Physicians love to hate payers. They pay doctors too little, their CEOs too much, and are all in a conspiracy to drive physicians crazy or out of business, whichever comes first.
We know. We hear you.
But however valid the criticisms — however real the injustices — physicians and payers need to work together. Want to get paid more and faster? Well, to do it, you’ll have to learn to get along with your payers. It’s time to stop pointing fingers and get to work.
So in the spirit of harmony, we asked payers what physicians can do to make things work better between them. (The opposite of our usual story in which physicians talk about what payers are doing wrong.)
Their simple request? Use more of the tools they’ve given you to make your office more efficient. “The most effective thing [physicians] can do is have themselves and their office staff really understand and use the tools that are available,” says Allen Karp, vice president of healthcare delivery for Aetna.
Not such bad advice.
Payers win too
“There has been a long history of [physicians and payers] pointing fingers at each other. Payers say, ‘We’ve given physicians what they need; they just don’t take advantage of [those things],’” says Nancy Brown, senior vice president of new product line development for athenahealth, a revenue cycle management company that works with practices around the country. But payers and practices don’t have to work at cross purposes. You have more in common than you may realize.
Melissa Lukowski spends her days talking to payers as athenahealth’s director of payer outreach. She says the “overarching theme” of many conversations is that payers “feel that they are always demonized by the providers, no matter what they do. Forward-thinking payers actually are trying to make things easier,” she insists.
Payers aren’t watching out for you simply out of affection, of course. If you work smarter and cheaper, their operations are smarter and cheaper, too.
Consider this: It costs you $8, at least, every time your biller gets on the phone to check on the status of a claim. She’s paid well and hourly. It takes her time to gather the information she needs, find the number, sort through the phone tree, and wait on hold. After all that, she’s worn out. So she walks down the hall for a cup of coffee before making the next call.
That’s bad for you.
But what’s happening at the other end? The insurer is paying plenty of employees whose job is to sit around waiting for your biller to call. They have to look up the claims, juggle calls, and deal with angry people all day long. They need a place to sit, a desk, a phone, a computer… You get the idea.
You see this situation isn’t ideal for payers either.
But what if your biller went online to check claim status, as most major payers allow her to do? It’s faster for her, cheaper for you, and cheaper for the payer. Everybody wins.
