Government
Delegates say insurers should have same deadlines as doctors
■ The AMA should seek legislation so managed care companies and other payers have only 180 days during which to seek a refund from physicians.
By Damon Adams — Posted Dec. 4, 2006
- INTERIM MEETING 2006
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Las Vegas -- If doctors have a limited amount of time to file a claim for services, health companies and Medicare should have a limited time to request a refund from a physician. That's according to an American Medical Association policy passed at last month's Interim Meeting.
Physicians said all they want is fair treatment. The new policy calls on the AMA to seek legislation requiring managed care companies and any third-party carriers, including Medicare, to request a refund from physicians for overpayment in the same time period they give physicians to file a claim.
"The playing field ought to be the same," said AMA Trustee J. James Rohack, MD, a cardiologist in Texas.
The new policy also calls for the AMA to seek legislation that health plans, Medicare and other payers in no case be allowed more than 180 days to request a refund from a physician.
"A lot of it has to do with simple business dynamics," Dr. Rohack said.
Florida delegates brought the issue to the meeting. They said health companies have extended periods to request refunds from physicians. In Florida, they said, companies have 30 months to request a refund.
In contrast, doctors nationwide typically have 90 days to file a claim for services rendered with health plans or they will not be paid, delegates said.
Some physicians said their finances are set back when health companies take too long to request a refund for an overpayment. They said the new policy would make it a little easier to work with health plans.
"It's nothing more than fair business practice," said delegate James Goodyear, MD, a general surgeon in Lansdale, Pa.
"That's what we deserve."
