NJ docs to track insurance denials — in hopes of helping patients more
The Medical Society of New Jersey has launched a new insurance denial registry for physicians' offices to help track denials of healthcare services to New Jersey consumers.
Physicians and patients alike get frustrated when medical services that are supposed to be covered by insurance are denied, MSNJ CEO Larry Downs said. But until now, there hasn't been a systematic way of tracing which companies, which procedures and what what types of drugs are routinely denied, he said.
MSNJ is giving doctors and patients a way to register the types of denials and the types of insurers making those denials. Downs said that information will be useful to policymakers and the public.
Common reasons for coverage denial include a policy change from the insurer — for instance, a new prior authorization requirement that an insurer applies to an imaging procedure, or for a certain medication. Downs said the MSNJ wants to know both the type of policies that are being applied and the reasons they're being applied to better help physicians get patients get the care they need.
Patients can file complaints through the registry. All contributions to the registry are strictly confidential.
Downs said he expects many physicians offices to contribute data.
"It disrupts patient care. It disrupts office workflow. We currently investigate those complaints on a case-by-case basis," he said. "But never before had we had the ability to collect all of that in a single database and analyze it for trends over time."
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