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1993.08.04 :  Performance of Medicare Carriers

Contact:  Anne Verano  (202) 690-6145
August 4, 1993

     A pilot survey of physicians in five states has found that most physicians
are satisfied with the performance of the Medicare carriers that process their
claims.  The pilot survey was conducted by the Health Care Financing
Administration and developed in consultation with the American Medical
Association and the American Society of Internal Medicine.
     "This is the forerunner of a similar survey that will be conducted in every
state next year as we continue our efforts to improve the working relationships
between physicians and the Medicare program," said Bruce C. Vladeck, who
directs the Medicare program as administrator of HCFA.
    Survey findings showed that:
    ùNearly 70 percent of the physicians indicated satisfaction with the
promptness of payments, and 79 percent were pleased with electronic claims
processing services.
    ùMore than 60 percent of the respondents rated as good to excellent the
politeness and helpfulness of carrier staffs, accuracy of payment calculations,
and timely distribution of information on program changes.
    ùCarrier-conducted seminars were rated as good to excellent by 72
percent of the physicians.
     "The study has helped us to identify problems as well as activities in which
carriers are performing well," Vladeck added.
     Vladeck said the survey showed that "improvement is needed in responding
with timely and clear information to doctors' phoned and written inquiries."
     Carriers, insurance companies that work under contract with HCFA,
represent the Medicare program in nearly all of the day-today business with
physicians.
     "The survey showed us that physicians consider the knowledge and skill of
carrier staffs to be of paramount importance," Vladeck said.  "Doctors want
and need accurate information and clear directions so they can operate within
Medicare policy."
     The survey form, which included 21 questions on carrier operations, asked
physicians to rate the service they receive from carriers.  Questionnaires were
sent to 2,500 doctors -- 500 each from the states of Florida, Georgia, Michigan,
Oklahoma and South Dakota.

EDITOR'S NOTE: HCFA, an agency of the U.S. Department of Health and
Human Services, helps pay the medical bills of 36 million Medicare
beneficiaries and 31 million Medicaid recipients.  HCFA's estimated fiscal year
1993 expenditures are almost $230 billion.