Doctors' Survey: Insurance companies impede patient care

Health coverage companies often barricade needed patient attention through holds in processing claims and intercession by unqualified personnel, according to a first-ever survey of Houston-area physicians.

In the Townsend Townsend Harris County Checkup Society's "Payor Survey," 487 local docs rated the six biggest coverage companies in Harris County on patient care, payment and client service.

The non-scientific online survey, conducted by the Healthcare Administration Program at the University of Houston at Clear Lake, was sent to 5,700 country physicians. Roughly 10 percentage responded.

Those that did gave cellar-level ratings to all six of the major wellness coverage companies operating in the country — Aetna, Blue Cross Blue Shield of Texas, Cigna, Humana, United Healthcare and Unicare.

Officials of the coverage companies were not immediately available for comment, or said they were preparing responses.

Greg Bernica, chief executive officer of the Townsend Harris County Checkup Society, said the grouping had hoped to rank insurance companies from best to worst. Instead, the companies all scored so low there was not adequate statistical difference to make an existent ranking.

"They all came in last," he said.

Society President Dr. Michael Emmett Kelly said the grouping isn't looking to begin a warfare with coverage companies but a duologue about how to break function patients and the large concerns that wage coverage insurance premiums for their workers.

"Our end was to acknowledge good public presentation and place problems. The consequences were dingy at best," Emmett Kelly said.

The study found:

• 70 percentage of doctors responding said coverage companies had denied claims for medically necessary procedures.

• 66 percentage said they had problem getting coverage company preauthorization for scans and other imaging.

• 83 percentage said the red-tape and delayed payment involving coverage companies required them to fill up at least one, and often two or three, administrative places per physician to cover with filing and charge issues.

lynn.cook@chron.com