Get answers to your questions about physician-rating systems
The Texas Medical Association has several tools available on physician-rating systems by Blue Cross and Blue Shield of Texas. Go to the practice management page of TMA’s Web site, www.texmed.org, for information on what BCBSTX’s ratings mean, what you can do to contest your ratings and how to improve your practice performance.
Managed care contract negotiation guide
To help members through the maze of managed-care contract negotiations, AAFP has developed a 12-page guide that takes members step-by-step through the process. Have your AAFP member number and password handy when you’re asked to log in. Click here to go to the Private Sector Advocacy page, then follow the link in the spotlight box.
Request bundling policies from MCOs
Under SB 418, the Prompt Pay bill from the 78th Legislature, health plans are required to disclose fee schedules along with any bundling logic that effects physician payment. Click here for a form letter that you can send to health plans requesting payment policy and bundling guidelines.
AAFP’s Health Plan Complaint Form
Have a gripe about a managed care plan? Register your complaint with AAFP’s Health Plan Complaint Form. You can fill out the form online or print it out as a pdf so that different members of your staff can complete sections that pertain to them. You can also view all of the complaints filed so far to see if other members are having similar problems. Data AAFP gathers through this form will be used to grade third party payers in what could be considered a health plan report card in a future issue of Family Practice Management, so fill out forms on your payers and make your experience count.
Tips for working with high-deductible health plans and HSAs
Check out AAFP’s extensive resources concerning the effects of consumer-directed health care on physicians’ practices. Click here.