Payer Report Card Payer Report Card This survey is designed to gather information about various health plans in Michigan, for members to use as a guide when contracting with these health plans and for MSMS to use in our advocacy efforts. OK Question Title * 1. On average, how long does a clean, electronic claim take to get paid or denied? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 2. On average, how long does it take to get a response on an appealed claim? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 3. When contacting a health plan representative, via telephone or email, on average, how long does it take to get a return telephone call or a response to an email? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 4. What is the average hold time you must wait until you are able to speak to a person when calling a health plan's provider servicing line? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 5. On average, what is the percentage of claims that are accurately adjudicated upon initial submission? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 6. When you submit medical documentation to support a claim submission or claim appeal, on the average, how many times do you have to submit the documentation before claim resolution is determined? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 7. For claims that require prior authorization, on average, what is the percentage of claims paid upon initial submission? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 8. On average, what is the percentage of claims reimbursed accurately according to the patient’s benefit plan? (Proper out-of-pocket costs are applied) Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 9. On average, what is the percentage of claims processed accurately according to the patient’s benefit plan? (Reimbursed for a service that is covered under the plan) Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 10. Are you able to access the payment/medical policies through the health plan’s website? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 11. If so, is it easy or difficult to access/find? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 12. On average, how long does it take to complete the prior authorization request for a medical service? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 13. On average, how long does it take before you get an approval or denial of authorization for a medical service? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 14. Does the health plan use a vendor to process prior authorizations for medical services? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 15. On average, how long does it take to complete the prior authorization request for prescription drugs? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 16. On average, how long does it take before you get an approval or denial of authorization for prescription drugs? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 17. Does the health plan use a vendor to process prior authorizations for prescription drugs? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 18. How often does the prior authorization process delay access to medically necessary care? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 19. How often does the prior authorization process result in a barrier to care for the patient? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 20. Has the administrative burden of the prior authorization process changed in the last five years? (Increased or Decreased) Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 21. How long does it take to complete the enrollment/re-enrollment application? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 22. On average, how long does it take to get a response on a provider enrollment/re-enrollment application? Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 23. Overall, rate each health plan based on ease of doing business satisfaction. 1 = Extremely Dissatisfied - 5 = Extremely Satisfied Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 24. Overall, rate each health plan based on problem resolution satisfaction. 1 = Extremely Dissatisfied - 5 = Extremely Satisfied Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Question Title * 25. Additional comments... Aetna BCBSM Blue Care Network HAP Humana McLaren Meridian Molina PHP Priority Health UnitedHealthcare Upper Peninsula Health Plan OK Thank you for taking the time to participate in this survey? OK DONE