Insurance Issues Resolution Committee

2018 Changes

Since 1998, GLMS has staffed committees that met regularly with the different insurance carriers in this region to facilitate the resolution of hassle reports, communicate trends identified by GLMS members and address concerns regarding new payer initiatives. These committees were originally named Quality Improvement Teams and then most recently Insurance Issues Resolution Committees.  Along with GLMS staff, each committee was appointed a member physician chairperson and a representative from the Louisville Chapter of the Medical Group Management Association (LCKMGMA).  Physician practices submit specific or general problems/hassles with the carriers to GLMS after first going through the appropriate channels to resolve the concern directly with the carrier. These issues are recorded as GLMS Hassle Reports and communicated directly with carrier representatives on a regular basis.  

As of August 2017, the  IIRC commtitees will no longer meet in person on a regular schedule but GLMS remains committed to providing support and resources to members and thier staff in regards to insurance related issues and concerns. 

Hassle Reporting - GLMS will continue to foster and develop relationships with the individual payers to ensure member hassles and issues are addressed expediently. The Hassle Report Form is a steady and growing part of the department’s functions and is a benefit that provides a substantial ROI for our members. The communication channels and relationships made between the PEPS department and the representatives at each insurance company throughout the years are critical to GLMS’ success in assisting with insurance related issues.

IIRC Roundtables - We will also continue to host the annual Medicaid IIRC Roundtable and the annual Private Payer Roundtable, which provide an opportunity for face-to-face interaction with payer representatives for GLMS members and their staff. The annual roundtables are well-attended and highly rated by our members based on surveys conducted after the meetings.

Payer Advisory Groups - Many of the payers GLMS currently works with now have a provider council/advisory group that duplicates what the GLMS IIRCs currently do, and they have invited GLMS to be a part of those. GLMS is committed to representing its membership by participating in meetings of payer Provider Councils/Advisory Groups.