Reminder: Review Your Physician Designation Data -- UPDATED

A key deadline is rapidly approaching for some physicians who hold contracts with UnitedHealthcare, or UHC. Jan. 27 is the cutoff for requests that UHC re-examine the accuracy of certain physician performance data the insurer has gathered before going public with it in early March.

Family physicians who practice in markets that utilize the UnitedHealth Premium physician designation program should already have received letters from the insurer detailing the process.

The letters, dated Dec. 23, informed physicians that their individual quality and cost-efficiency assessment results had been completed and would be made available to the public no earlier than March 4, 2009.

Physicians who have concerns about the accuracy of their data, and who can provide documentation that shows that patient information was incorrectly captured, can request a "reconsideration" of their UHC designation.

Physicians need to act quickly. Reconsideration requests, including all the necessary documentation, must be postmarked, faxed or e-mailed to UHC by the January deadline to give the insurer enough time to review and process the requests, said Marilyn Levi-Baumgarten, UHC's director of the UnitedHealth Premium designation program.

To be considered, a written request must include the physician's comments on UHC's Designation Detail Report, along with the physician's signature.

"We're saying that if you get your request in by Jan. 27, then we'll get it completed in time to impact the designation results that are released at the beginning of March," said Levi-Baumgarten.

UHC will review reconsideration requests received after the deadline, and physician designation ratings will be changed if indicated, "but we can't guarantee that we'll have that review complete by the time we finish the new designation posting," she said.

Most late reconsideration requests will be completed about 30 days after they are received, added Levi-Baumgarten, and updated designations will post weekly on UHC's online physician directory.

According to Trevor Stone, an AAFP private sector advocacy specialist, the AAFP has ongoing concerns about short timelines for requests such as this one. Academy members require sufficient time to review their detailed designation reports and respond by the deadline given, said Stone.

For instance, "a common industry standard for timely filing of claims is, typically, 90 days," said Stone. However, in this instance, physicians were given only 36 days from UHC's letter mailing date to the deadline for making their reconsideration requests.

The Dec. 23 mailing date UHC chose was unfortunate for a couple of other reasons, he added. The high volume of holiday mail may have caused some delivery delays, and some physicians undoubtedly were away from their practices on holiday vacations.

Stone noted that the AAFP Commission on Quality and Practice has worked to identify an appropriate review timeline for such situations. The commission will send a proposal to the AAFP Board of Directors for consideration at its April meeting that would ask health insurers to adhere to the following standard: "Provide a minimum of 120 days for physicians to review, validate and appeal their payer’s performance report before public reporting."