MedClaims Liaison (MCL), a leading national patient advocacy company, and Autism Speaks, the world’s largest autism science and advocacy organization, released the results of a joint survey demonstrating families seeking autism-related care are bewildered by the myriad challenges they face obtaining proper insurance reimbursement.
The survey was initiated in December 2011, when over 28,000 requests for participation were sent to advocates who have registered to receive alerts from Autism Speaks in six states where autism insurance reform laws have been enacted - California, Texas, New York, Pennsylvania, New Jersey and Connecticut.
·A majority of respondents indicated their confusion around their own state’s law and how it impacts their coverage:“While it is well known that this patient population suffers from acute financial burdens and a stressful reimbursement landscape,” said Mitch Kaye, CEO of MedClaims Liaison, “the survey revealed challenges even greater than we had anticipated. Most troubling is the number of families – 86 percent -- who would utilize more necessary care for their children if some of the difficult reimbursement issues did not exist. MCL’s mission is to reduce this burden and improve the financial outcomes for the families – we are very committed to this community. ”
- 26% responded “I don’t know” when asked if they lived in a state that has passed autism insurance reformunaware that in fact laws were in place
- 68% said they lived in a state that had passed reform, but 53% did not know how their own particular health insurance policy was regulated by the law
- A majority of respondents (54%) characterized the quality of coverage for autism-related services provided under their policy as “poor” or “unacceptable”; more than half obtained services from healthcare providers who do not accept their insurance
- 77% of respondents are frustrated by the process of dealing with medical bills and reimbursements
- 47% say the amount of time they have had to spend on claims and reimbursements has conflicted with work
- 55% are having trouble affording their medical expenses
- The lack of understanding is severely impacting access to reimbursements as 40% of respondents said they “never” submit claims if they do not think the treatment will be covered by their policy