MDNews - San Antonio

C AN YOU THINK of anything more important than your health? We are fortunate in this country to have the greatest physicians, nurses and healthcare techni- cians in the world. If you are ill, have a life-threatening emergency or just need your annual checkup, you want an accurate diagnosis and someone very experienced making the prognosis. You want to be returned to good working order in the shortest time possible. Sounds Easy, Right? Can you think of anything more complex than the human body? The point is that physicians and other healthcare providers have a very important place on this earth — and they are out there saving lives every day! They are typically the "brightest and best." The art and science of healing people is extraordinary, but these superb healthcare providers are being undervalued by insurance companies — more and more. A recent survey revealed that 57 percent of young physicians 40 years of age and under are pessimistic about the future of the U.S. healthcare system. Another study, commissioned by the Physician Foundation, concluded that physicians are working fewer hours, seeing fewer patients and limiting access to their practices in light of significant changes to the medical practice environment. The research estimates that if these patterns continue, 44,250 full-time equivalent physicians will be lost from the workforce in the next four years. Worse, the cost of becoming a physician has soared, while average salaries are declining. Nearly one-third of doctors — 28 percent — saw a cut in pay last year according to NerdWallet Health research. Have You Ever Thought about How Physicians Get Paid? Most physicians and hospitals rely heavily on payments from insurance companies. The U.S. healthcare system relies heavily on private health insurance as well as government subsidies provided by Medicare and Medicaid. Historically, physicians and hospitals have not been paid on time by the insur- ance companies. Time is money! How frustrating it is to save lives and help people with their healthcare needs only to be paid slowly by those who owe you money — in this case, the insurance companies. There is a history of underpay- ment by the insurance companies, as well, to further erode the predictability of a physician's cash flow. Texas Prompt Pay Act There is a little-known law — the Texas Prompt Pay Act (TPPA) — passed by the Texas legislature in 2003 to resolve the serious and frequent practice of insurance companies making late payments of healthcare claims to Texas physicians, hospitals and pharmacies. The TPPA sets forth penalties, interest and legal fees to be paid by the insurance companies if they do not pay submitted claims on time. The potential recovery for physicians, hospitals and pharmacies under the TPPA can be significant. The statute of limitations for the TPPA allows physicians, hospitals and pharmacies to go back four years to collect what is owed them — newfound mone y. He a lt hc a re profe s sion a l s deserve the right to be paid what they are worth. State-of-the-art technology today has made possible the seemingly impossible task of collecting medical billing data. Every physician, hospital and pharmacy should collect what is owed from this country's insurance companies. They deserve it! Healthcare Recover y Advisors, LLC (HR A) is an Austin-based company made up of C-level executives and former THA leaders with more than 70 years collective experience in the healthcare industry. We provide advisory services to physicians, hospitals and pharmacies for the recovery of penalties and interest owed them from insurance companies under the Texas Prompt Pay Act. ■ By Bill Pollock, Co-founder of Healthcare Recovery Advisors MURK Y WORLD OF INSUR ANCE COMPANIES: PHYSICIANS AND THE TEXAS PROMPT PAY ACT ++++++++++++++++++++++++++ +++ + +++ + ++++++++++++++++++++++++++ INSURANCE UPDATE M D N E W S . CO M ■ MD NEWS San Antonio | 1 5

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