Want to document an unfair payer practice or express frustration with a health plan's slow response to a particular problem? Family physicians have the opportunity to do just that with AAFP's Health Plan Grievance Registry (formerly known as the Health Plan Complaint Form). The registry is accessible through the Private Sector Advocacy section of the AAFP Web site.
Health Plan Grievance Registry
Member Input Drives AAFP's Private Sector Advocacy
By News Staff
3/13/2007
The registry was first made available to members in February 2006 in response to member requests. To date, 110 members have logged in to report some difficulty with a payer.
However, an uptick in member participation will help direct efforts by AAFP's private sector advocacy staff to communicate member dissatisfaction to health plan decision makers.
"Our members drive the actions we ultimately take," said Laura Schmidt, AAFP private sector advocacy specialist.
Rather than addressing physician complaints one by one, the registry is designed to track problematic trends in insurers' dealings with FPs. Even in its previous form, the system worked well during the past year, as evidenced by examples of Academy interventions that resulted in
However, an uptick in member participation will help direct efforts by AAFP's private sector advocacy staff to communicate member dissatisfaction to health plan decision makers.
"Our members drive the actions we ultimately take," said Laura Schmidt, AAFP private sector advocacy specialist.
Rather than addressing physician complaints one by one, the registry is designed to track problematic trends in insurers' dealings with FPs. Even in its previous form, the system worked well during the past year, as evidenced by examples of Academy interventions that resulted in
- an expedited credentialing process with CIGNA,
- enhanced communication between UnitedHealthcare and physicians regarding fee schedule changes, and
- ongoing conversations with Anthem regarding its policy of bundling CPT codes that should be paid separately.
The grievance registry form takes just minutes to fill out and can be completed by a member of the office staff after the physician member logs into the site with his or her AAFP ID number, said Schmidt.
Members interested in tracking trends on their own can use a new feature that allows users to search the registry by payer or state.
Members interested in tracking trends on their own can use a new feature that allows users to search the registry by payer or state.
