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Treating Patients & Haggling With Insurers

Mon, 09/12/2011 - 7:29am
Published August 30 by NYTimes.com

Pauline W. Chen, MD

A former colleague from Canada who practiced medicine with me here in the States never hesitated to make one thing clear to me: He couldn't wait to get back. It wasn't the cultural life that he missed, nor was it the ex-girlfriend I always suspected he pined for. It was the medicine.

''It's different,'' he would say wistfully, without elaborating. ''Practicing medicine is just different over there.'' A study published this month in the journal Health Affairs made me think of my colleague again and offered one likely possibility for his return to Canada: There, he had more time to focus on his patients.

Researchers asked hundreds of physicians and administrators in private practices across the United States and Canada how much time they spent each day with insurers and other third-party payers, tracking down information for claims that were denied or incorrectly paid, resolving questions about insurance coverage for prescription drugs or diagnostic tests, and filing the different forms required by each and every insurance company.

Physicians in Canada, where healthcare is administered mainly by the government, did spend a good deal of time and money communicating with their payers. But American doctors in the study spent far more dealing with multiple health plans: more than $80,000 per year per physician, or roughly four times as much as their northern counterparts. And their offices spent as many as 21 hours per week with payers, nearly 10 times as much as the Canadian offices.

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