Navigating a maddening maze of phone menus and waiting endlessly on hold are enough to give anyone a headache. But for migraine patients and others whose symptoms are worsened by stress, struggling with their insurers’ automated call system may prolong real pain.
Now, a new initiative called “Time is Money” could help reduce those burdens and ease patients’ access to their health insurer’s information.
Effort to Limit “Hassle and Hardship”
The White House led effort unites executive agencies in limiting “hassle and hardship” associated with filing claims and accessing plan information like which providers are in-network. Confusing websites and manual filing requirements that require printing, scanning and mailing forms will also be examined, according to cabinet officials.
The initiative builds upon recent regulatory review efforts by multiple agencies.
The Centers for Medicare & Medicaid Services, for example, has already been looking into the claims and approval processes of the programs for which it provides oversight. Meanwhile, the Department of Health and Human Services rolled out a post-pandemic program to allow online health insurance renewal and the Health.gov website has been evaluated and optimized for ease of use.
The government is now urging private companies to follow suit when it comes to process improvements. A list of recommendations has been provided via an open letter to health insurance CEOs as a better customer experience could translate into better health.
Mazes and Roadblocks Stymie Patients
In one recent survey, 58% of people with health insurance reported encountering problems using it in the preceding year. Many experienced denial of care, repeated requests for prior authorization, and unanswered questions about provider networks and medication formularies.
Some have alleged long telephone prompt menus and chat bot “doom loops” are deliberate obstacles intended to discourage patients into giving up on seeking care or filing for reimbursement.
Maze-like utilization management practices employed by health insurance companies – arguably to keep costs down – get in the way of timely access to care. Research has shown, however, that denying and delaying care uses more health care resources with repeated office visits, worsening of symptoms and disease progression.
Health insurance has to work for everyone, not just for healthy people or those with time to burn spending hours on the phone. The combined efforts of executive agencies under the White House’s new plan could go a long way toward giving Americans their time and money back.
