Most Popular Stories
- Dust earns evil eye from hospital surveyors
- Supreme Court: Residents' earnings should be taxed
- Walgreens plans to evolve health, wellness efforts
- Physician outreach should be a top EMR priority for 2011
- CMS issues draft of value-based purchasing rule
- Online appointment scheduling growing in popularity
- The Future of Telehealth, Telemedicine & Medical Technologies
March 17, 2011 – March 18, 2011 — Albuquerque, NM
- 7th Annual Mobile Healthcare Summit
January 25-26, 2011 — Holiday Inn Toronto Airport
- 2011 National Policy Forum
March 8-9, 2011 — Washington, DC
- National Health Policy Conference (NHPC)
Feb 7-8, 2011 — Washington, DC
FierceHealthPayer provides the latest news about the fast-changing and heavily regulated area of healthcare reimbursement. Join thousands of healthcare plan executives who get FierceHealthPayer via weekly email. Sign up today!
PPOs get poor marks for claims payment, customer service
Major insurers in California do a poor job of paying claims and providing good customer service for members in preferred provider organization plans (PPOs), according to a new state survey by the California Department of Insurance.
Anthem Blue Cross Blue Shield of California, Health Net, UnitedHealthcare and Cigna received the lowest possible ratings for customer service. Aetna earned a slightly better rating of fair, the Los Angeles Times reports.
Consumers complained about the difficulty of getting someone on the phone, obtaining cost information and getting claims paid, according to the Sacramento Bee.
California Insurance Commissioner Steve Poizner told the Los Angeles Times that the findings are "atrocious," saying insurers "must step up and improve the quality" of their healthcare services in a marketplace that generates $17 billion a year in revenue. "Consumers now have much more information to make choices that are best for them, and to pressure insurers to do better. We all need to use this data to make that happen," he said in a statement.
The survey also evaluated whether PPO members received adequate medical care through cancer screenings, cholesterol testing and other services. It found that Anthem Blue Cross Blue Shield and Health Net did a fair job of meeting quality standards spelled out by national experts. Aetna, Cigna and UnitedHealthcare did a good job of meeting those criteria, according to the Times.
Anthem, the state's largest PPO provider, said it aggressively analyzes data on claims, pharmacy services and health risks to notify members of gaps and make clinical recommendations. UnitedHealthcare said physicians now can process their claims almost immediately online, and nearly all such claims are handled within 10 days. It received one of the best overall ratings of the six major PPO companies, earning scores of good for medical care and timely access to doctors. Cigna said it has simplified its explanations of benefits to make them easier to understand to help improve customer service scores.
Check out more news by topic
Affordable Care | AHA | AHIMA | AMA | American Hospital Association | American Medical Association | American Recovery and Reinvestment Act | ARRA | Centers for Medicare and Medicaid Services | Cerner | Charity Care | Cigna | Computerized Physician Order Entry | CPOE | David Blumenthal | Department of Health and Human Services | Electronic Health Records | Electronic Medical Records | EMR Adoption | Epic Systems | e-Prescribing | GE Healthcare | HCA | Health 2.0 | Health Information Exchange | Health Insurance Portability and Accountability Act | Health Plans | Health Reform | Healthcare Costs | Healthcare Financial Management Association | Healthcare Reform | HFMA | HHS | HIMSS | HIPAA | Home Monitoring | Hospital Construction | Hospital Corporation of America | Hospital Finance | Hospital Layoffs | Hospital Strikes | Humana | Ingenix | Interoperability | Kaiser Permanente | Kathleen Sebelius | Mayo Clinic | McKesson | Meaningful Use | Medicaid | Medical Group Management Association | Medical Malpractice | Medicare | Medicare Fraud | Medicare Part D | Medicare Reimbursement | MGMA | mHealth Initiative | Moody's Investors Service | Office of the National Coordinator for Health Information Technology | Patient Collections | Patient Privacy | Patient Safety | Pay for Performance | Personal Health Records | Physician Compensation | RAC | Recovery Audit Contractor | Remote Monitoring | Remote Patient Monitoring | Siemens | Telehealth | Telemedicine | UnitedHealth Group | Wellpoint | Wireless Health |
Home | Subscribe | Advertise | Mobile Edition | RSS | Privacy | Site Map
THE FIERCEMARKETS NETWORKFierceFinance | FierceFinanceIT | FierceComplianceIT | FierceHealthcare | FierceHealthFinance | FierceHealthIT | Hospital Impact | FierceMobileHealthcare | FierceHealthPayer | FiercePracticeManagement | FierceEMR | FierceCIO | FierceCIO:TechWatch | FierceContentManagement | FierceMobileIT | FierceGovernmentIT | FierceBiotech | FierceBiotech Research | FiercePharma | FierceVaccines | FierceBiotechIT | FiercePharma Manufacturing | FierceMedicalDevices | FierceDrugDelivery | FierceIPTV | FierceOnlineVideo | FierceTelecom | FierceVoIP | FierceBroadbandWireless | FierceDeveloper | FierceMobileContent | FierceWireless | FierceWireless:Europe | FierceCable
© 2011 FierceMarkets. All rights reserved.