Insurance Hassle Reporting
One of the most utilized services offered by the GLMS Physician Education and Practice Support Department is Hassle Reporting, where providers can report on-going insurance issues to GLMS and we work with the payers daily and track these issues to identify trends. On average, hassle reports that are resolved have resulted in a savings of approximately $2,600 for each physician case.
Since 1998, GLMS has fostered and developed relationships with the Insurance Payers to ensure member hassles are addressed expediently. The Hassle Report Form originally named the Hassle Factor Log, is a steady and growing part of the Society's functions and is a member benefit that provides a substantial ROI for our members. The communication channels and relationships made between the GLMS PEPS department and the representatives at each insurance company throughout the years are critical to GLMS’ success in assisting with insurance-related issues.
Physician practices submit specific or general insurance hassles to GLMS after first going through the appropriate channels to resolve the concern directly with the payer. Submitted hassles are recorded in a secure database and addressed directly with carrier representatives on a regular basis.
Over the years, reported hassles have involved inappropriate bundling of services, nonpayment for certain medications/vaccines or procedures, unreasonable pre-certification procedures, long hold times, incorrectly denied claims, policy issues, improper payer notifications and lack of payer response or follow-up. Frequently, these complaints are not isolated but are found to be a common trend experienced by multiple physician practices regarding the same carrier. For this reason, it is imperative that practices notify GLMS of existing problems so that they may be resolved with the insurance carrier. The execution of the solutions to these problems is followed up by the GLMS staff on a daily basis.
* The GLMS Hassle Reporting service is available to GLMS member physicians and their practice staff and will help us determine how we can best support practices in addressing private payer and practice management issues of concern.
What Hassle Issues are Trending in 2018?
Below is a list of hassle topics that have been reported so far in 2018. These are issues that have been addressed with payers and some of are still in process. If you are experiencing these or other hassles with getting paid correctly, let us know. * Many of these issues have been reported by multiple practices but are only listed once on this list.