Survey: MGMA members satisfied with major payors claims payment

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Most Medical Group Management Association (MGMA) members are satisfied with the disclosure of payors’ fee schedules and prompt payment of claims by major health plans, according to an association survey.

The MGMA’s second annual poll to determine group practice professionals' attitudes about payor interactions focused on seven payors--Aetna, Anthem, Cigna, Coventry, Humana, Medicare Part B and UnitedHealthcare. More than 1,700 practice professionals participated in the poll. Results reflected the members’ perceptions of the payor environment in areas of communication, provider credentialing, contracting, payment policies, system transparency and overall satisfaction.

On the question of overall satisfaction with payor performance, Medicare Part B topped the list with a rating of 3.59 (based on a five-point scale). It was followed by Aetna with a 3.14 rating and Cigna with a 3.11. The lowest-rated payors were UnitedHealthcare with 2.45 and Anthem with 2.84.

According to MGMA, surveyed members were highly satisfied with the provider credentialing processes of private payors, but were dissatisfied with the process for Medicare. Aetna was the highest rated health plan at 3.31, followed by Anthem at 3.28--Medicare Part B at 2.95 and United Healthcare at 2.98 were the lowest.

“We believe this is a result of Medicare’s refusal to participate in the standardized physician credentialing system (CAQH Universal Provider Datasource) that is widely used in the private sector,” said William F. Jessee, MD, MGMA president and CEO. “Our members appreciate payors that provide clear, consistent processes, especially processes that are based on industry-wide standards.”

Every payor received a rating above three (neutral) on the question of satisfaction with the promptness of claims payment. Medicare Part B was at the top of the list with a 4.11 rating average, followed by Aetna at 3.50.

Members also gave Medicare Part B the highest marks on questions related to responsiveness and transparency.

“Despite the fact that Medicare consistently underpays and places member practices in an increasingly difficult financial situation—with a looming 21 percent cut to physician payments—MGMA members were positive about the standardized and predicable nature of how the program is administered,” said Jessee.