December 2001 Bulletin

81% orthopaedists report delays in reimbursements

Eighty-one percent of orthopaedic surgeons who treat workers’ compensation patients report they experience delayed reimbursement of claims and 71 percent say they receive inadequate reimbursement.

Responding to a workers’ compensation survey developed by the AAOS department of health policy, 91 percent of the orthopaedists say they encounter administrative hassles.

Census regions. Northeast: Maine, N.H., Vt.,Mass., R.I., Conn.  Middle Atlantic: N.Y., N.J., Pa.  East North Central: Ohio, Ind., Ill., Mich., Wisc.  West North Central: Minn., Iowa, Mo., N.D., S.D., Neb., Kan.  South Atlantic: Del., Md., D.C., Va., W.Va., N.C., S.C., Ga., Fla.  Mountain: Idaho, Wy., Colo., N.M., Ariz., Utah, Nev.  Pacific: Wash., Ore., Calif., Alaska, Hawaii.  East South Central: Ky., Tenn., Ala., Miss.  West South Central: Ark., La., Okla, Texas

Analysis of the data by the AAOS department of research and scientific affairs found delayed reimbursement problems are "definitely" or "somewhat of a problem" for 90 percent of the respondents in the Mid Atlantic region. In the Pacific region, 86 percent of orthopaedists said it is a definite or somewhat of a problem; the East South Central, 84 percent; and South Atlantic, 83 percent.

Inadequate reimbursement is a significant problem for 81 percent of respondents in the South Atlantic region; 80 percent in the Mid Atlantic region; and 79 percent in the Pacific region. However, inadequate reimbursement is not a problem for nearly half the respondents (46 percent) in the West North Central region and more than 40 percent of orthopaedists in the East South Central and East North Central regions.

Ninety-eight percent of the 1,270 respondents to the survey, which was distributed in July 2001, said they treat workers’ comp patients. Thirty-eight percent said they do not limit or control the types of patients they see. But analysis by census region found half of the respondents from the South Atlantic region reported limiting or controlling their workers’ comp patients, while just over one-fourth of the respondents in Mid Atlantic and New England regions do.

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