The new provision of the federal health law that waives cost sharing for women鈥檚 preventive health services may be a mandate on insurance companies, but it鈥檚 providers who are complaining about its burden.
That鈥檚 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 don鈥檛 renew for months or even years still face co-pays until that time.
Anders Gilberg with the a national organization representing doctors鈥� groups, said that means practices will likely have to call each patient鈥檚 insurance plan when they show up for a preventive visit.
鈥淭he way you have to go about checking eligibility for each plan would be different. There鈥檚 not one way, one portal, to check it,鈥� 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 isn鈥檛 an option, Gilberg says, because that would violate providers鈥� 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 weren鈥檛 expecting.
Gilberg says practices are trying to educate patients about what preventive visits do and don鈥檛 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 patient鈥檚 insurance card and have pertinent billing information at their fingertips.
This story is part of a collaboration that includes , 聽and聽Kaiser Health News.