For Kentucky patients, finding a doctor has rarely been more difficult. More than 100 of the state’s 120 counties are dealing with a federally designated shortage of health professionals. By the end of this decade, Kentucky will face a projected shortage of nearly 3,000 doctors.

Two of the state’s health insurers — Aetna and Cigna — are making this crisis worse. Both firms have recently adopted a tactic known as “downcoding.” This is when an insurer automatically reduces the reimbursement level of a physician’s claim.

Insurers do not notify physicians when they downcode a claim. They simply do it. In a busy clinic seeing dozens of patients a day, these reductions can go unnoticed for weeks or months. They are not applied uniformly or predictably, which makes them even harder to detect. In some cases, the staff time required to identify and appeal these reductions costs more than the reimbursement physicians would recover — an outcome insurers are counting on.

Read the article at Louisville Courier-Journal