Colorado Medical Society

Introduced by: Arapahoe-Douglas-Elbert Medical Society

Subject: Nationwide Standardization of Reimbursement Policies for the

Insurance Industry

Referred to: Reference Committee on Health Affairs

WHEREAS, insurance companies throughout the United States each establish their own policies on reimbursement issues, e.g., bundling, coding, appeals of denied claims, etc., and

WHEREAS, the variance from one health plan to another creates significant, time-consuming problems for the physician and his/her staff, and

WHEREAS, the cost of medical care is increasing at an alarming rate, and

WHEREAS, physicians in private practice must retain additional staff to handle the filing and appeals process of insurance claims, thereby raising the cost of overhead for such physicians which contributes to the overall cost of healthcare, therefore be it

RESOLVED, that the Colorado Medical Society Delegation to the American

Medical Association take to the AMA House of Delegates a resolution calling for federal legislation that would standardize reimbursement policies, e.g., bundling, coding, appeals of denied claims, etc., and standardize recognition and application of modifiers and CPT Codes, as defined in the CPT Manual, so that they are uniform throughout the insurance industry.

FISCAL IMPACT: None