Wednesday, April 01, 2009

Health Insurance Co's to Stop Listing Dead Docs in Online Physician Directories

All health insurance companies in the US have promised to stop their practice of including in their online provider directories all physicians and other health care providers who have at some time in the past taken one of their patient members.  Instead, they will actually include only those providers who can take new outpatients. 


"This should end the frustration of having to call, say, all 37 psychiatrists in the directory, to find that only 3 are taking new patients, because the rest are either inpatient-only doctors, retired, deceased, moved, or have stopped taking new patient members because of our low reimbursement rates or our burdensome bureaucratic hoops we employ to drag out the payment process," said Lyle Waggoner, president of Big Corporate Business Shield of America, the nation's largest health insurer.

"Of course," he adds, "that means that we now only have 3 psychiatric specialists in our directory, but that's all we really had before anyway."  The American Psychiatric Association has praised BCBSA for negotiating this change in policy, which takes effect starting on April 1.

Industry experts predict that more patients will actually receive treatment, because many used to give up in frustration after the 10th or 15th phone call.  "We were considering adding 'Insurance Frustration Disorder', or IFD, to the upcoming DSM-V," said APA president-elect, Dr. Carol Bernstein, referring to the upcoming fifth edition of the diagnostic manual of psychiatric diagnoses used by insurance companies.  "We may now have to reconsider the diagnostic criteria."

Health care consumers who are looking for new providers are pleased with the change.  "I only had to make three phone calls to get an appointment in 3 months.  I used to have to make thirty calls, causing me to go to the ER for homicidal ideation," said Anna B., a BCBSA member in Chicago.  "I've heard that they may also make it so my doctor gets paid within 3 days after completing a simple online form.  Now that's crazy."

Insurance companies plan to prove the providers in their online directories are taking new patients by including next to their name the number of outpatient claims for new patients submitted in the most recently available 12 month period.