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Medicare not slow

Posted: Thursday, December 26, 2002

The Associated Press story "Doctors opting out of Medicare after funding cutbacks," taken from the Alaska Journal of Commerce story by Regan Foster, which ran in the Dec. 18 Juneau Empire, contains some incorrect and misleading statements.

There are not 3,620 Medicare participating doctors in Alaska. Our Part B carrier, which tracks participation and nonparticipation, reports that in 2002 Alaska had 1,371 participating doctors and limited licensed practitioners (LLPs) such as nurse practitioners, physician assistants, etc., and 221 nonparticipating doctors and LLPs, for a total of 1,646.

Also, Dr. Bruce Kiessling's statement that it can take between four and six months to process a single claim is very vague. While he did not specifically state that it takes Medicare (as opposed to other insurers) this long to process a claim, he implied that it did. I think the statement misleads readers to believe that Medicare routinely is a slow payer.

This is not true. While processing can be delayed because the claim is submitted lacking critical information or with incorrect information, Medicare Part B has an outstanding record in Alaska for processing clean (error-free) physician claims in a very timely manner. In fact, more than 99 percent of all clean claims submitted electronically in Alaska during the last five months were processed in fewer than 30 days. (The law prevents Medicare from paying before the 14th day after submission on electronic claims.) Between 98 percent and 99 percent of all paper claims submitted were paid within 30 days. (The law prevents Medicare from paying before the 27th day after submission on paper claims.) In fact the law requires that we pay interest when clean claims are not processed in a timely manner.

Physicians often tell us that Medicare pays faster than most other insurances.

Also, the final rule for the 2003 physician fee schedule, which will be published in the Federal Register on Dec. 31, will become effective March 1, 2003. Therefore, physicians will continue to be reimbursed at the 2002 rate through February.

Pam Negri

public affairs specialist

Centers for Medicare & Medicaid Services

Seattle Regional Office



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