 |
 Georgia delegate Tanya Jones, M.D., of Atlanta calls for "more aggressive" pursuit of reimbursement for paperwork. |
Family physicians have been giving away too much for too long. But thanks to two resolutions passed during the AAFP Congress of Delegates Oct. 12, the big giveaway may be coming to an end.
The resolutions call on the Academy to develop information to help doctors collect previously uncompensated administrative services, to work toward garnering third-party payment for administrative costs that insurers could bear, and to advocate a system that allows family doctors to collect for managing care of hospitalized patients who require subspecialists' services.
At the heart of delegates' call for action on reimbursement for paperwork costs are the ongoing -- and growing -- demands from managed care, Medicaid, Medicare and pharmaceutical companies. Third-party payers demand proof of patients' need for medical or assistance services.
Delegates contended collecting that information should rest with the organizations that demand it, not the physician who provides care. Added to patient requests for new prescriptions due to changing insurance formularies or for free help completing school physical forms, the financial burden of paperwork becomes overwhelming, delegates said.
Family physicians "are screaming for relief from paperwork," George Shannon, M.D., of Columbus, Ga., a member of the Commission on Continuing Medical Education, said during a reference committee hearing.
Georgia delegate Tanya Jones, M.D., of Atlanta agreed with Shannon. Noting that attorneys, accountants and other professionals charge clients for telephone calls and paperwork, she called on family medicine to "become more aggressive." In response, the Congress directed the Academy to "provide family physicians with information on how to bill and collect for clinical and administrative services not covered by insurance, and advocate with public and private insurers to recognize the value of, and to appropriately pay for, these services."
Moreover, delegates called on the Academy to help ensure physicians receive payment for managing and coordinating the care of hospitalized patients. Hospitals and subspecialists rely on family physicians for the continuity of care needed by hospitalized patients whose conditions require intervention by multiple specialists, said Wisconsin delegate Bradley Fedderly, M.D., of Milwaukee. However, most insurers refuse to pay two physicians for the same diagnosis under the same code. Most often, he added, they deny reimbursement to family doctors for their coordination and management expertise.
"There's a clear value to them (hospitals, specialists and insurers) to have us manage these cases, and it's something we should receive reimbursement for," said Fedderly.
The delegates concurred, calling on AAFP to "address adequate reimbursement of physicians providing management and coordination of complex hospital care and concurrent care utilizing the same diagnosis code, using strategies that may include coding and benefit and contractual design."
To reach writer Leslie Champlin, e-mail lchampli@aafp.org.
FP Report is
published by the AAFP News Department.
Copyright © 2004 by American Academy of Family Physicians.