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A Provider Navigates the Reimbursement Journey
Fred Pelzman, MD, shares his woes as he navigates the "growing demands" of insurance companies to make care more patient-centric.
The insurance companies have discovered a new way to give me a headache. About a month ago, a number of providers in our practice received an e-mail with instructions about a new task to which we had been assigned. Apparently, we were supposed to log on to some website, create an account, and fill out a SOAP note on about a dozen of our patients.
Wait, a SOAP note? Didn't I write one of these already when I saw them in the office?
According to the team that is the liaison with the insurance company, we are supposed to complete these long, detailed forms to show that we are "taking good care" of our patients. This information is being collected and, we discovered later, will be used in upcoming contract renegotiations, and our failure to do this could apparently cost our institution significant money when the final rate increase is calculated.
As expected, in what is normal behavior for busy clinicians, all of us essentially ignored the e-mail for the first month. A follow-up was sent, which made us groan again, and our continued ignoring led to a follow-up e-mail from our division chief informing us that these forms were "not elective."
So yesterday afternoon, with some blocked-off administrative time, I sat down at my computer to dutifully complete their SOAP notes.
Link to the article on Medpage Today: http://bit.ly/1x9MEE2
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
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Insurance Coverage Limits JAKi Therapy Access for Patients With AA, Especially Non-White Populations
April 25th 2024A survey study showed major barriers to Janus kinase inhibitor (JAKi) therapy for patients with alopecia areata, especially for non-White patients who face higher rates of being uninsured and struggle more to afford the treatment.
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