Doctors Will Have To Figure Out Who Gets ‘No-Cost’ Birth Control
The new provision of the federal health law that waives cost sharing for womens preventive health services may be a mandate on insurance companies, but its providers who are complaining about its burden.
Thats because not all women are eligible for the cost sharing waiver at the same time. The rule , but only for plans that are new or renewing after that date. Women with that dont renew for months or even years still face co-pays until that time.
Anders Gilberg with the a national organization representing doctors’ groups, said that means practices will likely have to call each patients insurance plan when they show up for a preventive visit.
The way you have to go about checking eligibility for each plan would be different. Theres not one way, one portal, to check it, he said.
The alternative is charging every patient a co-pay and then issuing a refund, which is poor customer service and wastes staff time.
Simply waiving all co-pays for preventive visits isnt an option, Gilberg says, because that would violate providers contracts with plans that require co-pays.
Another glitch providers expect is one they ran into when the law waived co-pays for some Medicare services. Patients made appointments for preventive screenings, but then asked providers to deal with other conditions that require co-pays, generating bills patients werent expecting.
Gilberg says practices are trying to educate patients about what preventive visits do and dont cover, and encouraging them to find out if their health plan is grandfathered before they show up expecting a free visit. That itself is a burden on practices, he notes. He says what practices really want is better information technology, so front desk staff can simply swipe a patients insurance card and have pertinent billing information at their fingertips.
This story is part of a collaboration that includes , andKaiser Health News.