Fisher Mark B, Bianco Fernando J, Triest Jeffrey A
Department of Urology, Wayne State University, Detroit, Michigan 48201, USA.
Urology. 2006 Feb;67(2):250-3. doi: 10.1016/j.urology.2005.08.024. Epub 2006 Jan 25.
To determine patient assumptions and opinions of the billing and reimbursement process in an urban urologic practice. Healthcare policy and physician reimbursement has been discussed in political and economic forums; however, few studies exist that reflect a patient's perspective of reimbursement issues.
An anonymous, voluntary 11-question survey was given to 825 patients during a 10-week interval. The instrument measured patient perceptions on the amounts (in percentages) that would, and should, be covered by insurance carriers and collected by their urologist. It also measured the time frames perceived for these events to occur. Our aim was to evaluate their knowledge of office urologic reimbursement.
Overall, 532 patients (75%) surveyed believed their insurance would cover 80% to 100% of their bill. A total of 309 patients (49%) thought their urologist would receive 80% to 100% of the bill, and 383 (60%) thought they should receive that level of compensation (P < 0.0001). Respondents with prior surgical contact thought their urologist would (P = 0.004) and should (P = 0.01) be reimbursed at a greater level than those without prior surgical contact. When asked about the time to reimbursement, 340 (73%) thought their doctor would be paid within 6 weeks compared with 453 (95%) who thought their urologist should be paid within that time (P < 0.0001).
The survey responses demonstrated patients' convictions that their urologists should be reimbursed in a timely manner. Additional studies examining both patient and healthcare provider perspectives are needed to better educate both of these groups on the medical billing and reimbursement process.
