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2026 Physicians Practice Payer Scorecard
1.
Which payers do your practice accept?
Commercial (private)
Medicare
Medicaid
None
2.
How many payers does your practice accept?
1-4
5-7
8-10
11-15
16-20
More than 20
3.
What are the biggest challenges with your biggest payer’s plans?
Addressing high copay/deductible issues with patients
Increasing rate of claim denials
Low reimbursement from the payer
Coverage verification
Getting paid
Other
None, no challenges with these plans
4.
Who at your practice negotiates payer contracts?
Physician
Practice manager
Other staff
Practice does not negotiate payer contracts
5.
How would you characterize your prior authorization experience in the last year?
We’re doing more prior authorizations
We’re doing fewer prior authorizations
Prior authorizations are about the same
6.
Does your practice use AI-integrated coding/documentation software?
Yes
No
7.
How do you think AI tools have changed your practice’s relations with your payers?
Made payer relations better
Made payer relations worse
No change
8.
PATIENT INFORMATION:
On a scale of one to 5, (1=poor; 5=excellent) how would you rate your largest payer on patient information topics, such as the clarity of the info on the patient’s insurance card, responsiveness to changes in patient data provided by your practice, the prior authorization process, and communication with patients on copays/deductibles
Poor
1 star
Below average
2 stars
Average
3 stars
Above average
4 stars
Excellent
5 stars
9.
PRACTICE COMMUNICATION:
On a scale of one to 5 (1=poor; 5=excellent), how would you rate your largest payer on practice communication, including clarity on who practice should contact with inquiries, notification of contract changes and formulary updates, ease of navigating their website/portal and phone systems.
Poor
1 star
Below average
2 stars
Average
3 stars
Above average
4 stars
Excellent
5 stars
10.
PAYMENTS/REIMBURSEMENT:
On a scale of one to 5 (1=poor; 5=excellent), how would you rate your largest payer on payment and reimbursement issues, including turnaround time, reimbursement rates matching what's specified in contract, claim success, fair/reasonable rate compared to other payers, and explanation and ease of appeal process for denied claims.
Poor
1 star
Below average
2 stars
Average
3 stars
Above average
4 stars
Excellent
5 stars
11.
CUSTOMER SERVICE:
On a scale of one to 5 (1=poor; 5=excellent) , how would you rate your largest payer on customer service topics, including response time to inquiries, time on hold when contacting customer service, willingness to negotiate on reimbursement rates and timeliness to respond to questions and/or issues.
Poor
1 star
Below average
2 stars
Average
3 stars
Above average
4 stars
Excellent
5 stars
12.
What is your biggest challenge with your larger payer? (OPTIONAL)
13.
How can payers improve their relationship with practices?
14.
How do you think AI will change the claims process?
15.
What is your practice’s specialty?
Family medicine
Primary care
Pediatrics
Internal medicine
OB/GYN
Surgery
Cardiology
Other
16.
What type of practice do you operate?
Solo practice
Independent group practice
Owned by hospital/health system
VA or other government system
Other
17.
Number of physicians at practice?
1
2-5
6-10
11-25
26 or more
18.
Number of support staff at practice?
1
2-5
6-10
11-25
26 or more
Current Progress,
0 of 18 answered