April 28, 2012|By Steve Kilar, The Baltimore Sun
The Maryland medical society and attorney general's office launched a website Saturday aimed at helping doctors file complaints with the state when insurance companies refuse to cover patient care.
"Essentially, our goal was to educate our patients and our physicians that there is an avenue for these complaints," said Gene Ransom III, CEO of MedChi, the state medical society. "We thought, 'Let's make it easier.'"
The site, called Insurance Watch, is hosted on the Internet by the medical society. Its primary purpose is to allow doctors to more easily "help patients when legitimate health insurance claims have been denied," according to the attorney general's office. But it also contains information for patients about filing insurance complaints on their own and allows MedChi to track doctors' complaints.
"It is extremely difficult to fight the insurance companies on your own," Attorney GeneralDouglas F. Ganslersaid in an interview. "To have the doctors involved is a very positive development."
Patients often think it's their doctor's fault that an insurance claim was denied, Gansler said. For that reason, he said, many patients go straight to their doctor if they have an insurance complaint.
In addition to acting as a one-stop shop for patients and doctors to find online forms for filing complaints with the attorney general or state insurance commissioner, the site includes a form that allows doctors to notify MedChi about each insurance complaint they file.
The medical society can then follow up with the attorney general's office to facilitate the gathering of information about the complaint, said Meredith Borden, deputy director of the attorney general's health education and advocacy unit.
In large part, the site is intended to raise awareness among doctors that they "have a right under Maryland law to file complaints on their patients' behalf," Borden said. Both doctors and patients benefit financially when insurance claims are paid properly, she said.
The website stemmed from a 2010 MedChi survey of Maryland doctors that asked their views about insurance authorization procedures. Respondents were overwhelmingly unhappy with insurance companies' ability to control the speed and manner of patients' care, Ransom said.
Last year, the attorney general's office received more than 2,000 complaints about insurance company practices, Gansler said. Consumers received more than $1 million in relief from insurers because of those complaints, he said.
Both those numbers will likely rise as awareness of the insurance complaint process increases among patients and doctors, he said.
Consumers can file complaints and find more insurance-related resources on the Insurance Watch site, http://www.medchi.org/iwatch/medchinew.html
steve.kilar@baltsun.com
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