5 findings on payer-provider communication gaps

While payers and providers view improved collaboration as a profitability driver, poor data transparency, contesting business goals and administrative burdens remain significant hindrances, according to a recent Availity survey.

Availity, a health information network based in Jacksonville, Fla., conducted a survey of 40 health plans and more than 400 facility- and practice-based providers about the state of payer-provider communication.

Here are five findings from the survey.

1. Forty-three percent of practice-based providers and 29 percent of facility-based providers experienced difficulty communicating with payers.

2. Sixty-one percent of facility-based providers and 51 percent of practice-based providers said patient communication regarding health plan benefits and financial responsibility is a challenge.

3. Seventy-six percent of payers and providers see administrative waste as a large contributor to communication gaps. Both parties listed redundant information requests, denied claims and inconsistent rules as top communication issues.

4. More than 90 percent of providers and 68 percent of payers said phone communication remains the most common means of communication between parties.

5.  Twenty-five percent of insurer respondents said online and multipayer portals would be their preferred means of provider communication. This is compared to 42 percent of facility-based providers and 35 percent of practice-based providers.   

More articles on payer issues:
Analysts: For-profit payers to grow Medicare, Medicaid businesses regardless of health law
Cleveland Clinic, CareSource may end contract
CMS increases estimate of counties lacking ACA exchange plans to 49

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