The Texas Medical Association offers its members an effective tool in their struggle with health insurance carriers. By using the Hassle Factor Log, physicians can voice their complaints to the people who know how to remedy the problems. Everything from delayed payments and claims denials to lost claims and late payment patterns can be submitted and will be given an in-depth review by the dedicated staff at TMA.

What can this do for me?
The TMA Health Care Financing Department will address your issues on the individual and statewide level. You will receive the one-on-one attention needed to quickly and effectively resolve individual issues. TMA will keep you up-to-date by providing copies of all correspondences with the insurance companies and working directly with your office and the payor. The Hassle Factor Log also allows TMA to recognize upcoming and present trends with many issues. Issues that show a pattern of deficiencies by the insurance companies are addressed in meetings among TMA staff, the TMA Council on Socioeconomics, Centers for Medicare and Medicaid Services, managed care plans, and large insurance companies. “Physician participation in the program helps TMA leaders and staff negotiate smoother reimbursement for all members through ongoing meetings with payers,” (Hassle Factor Log Program 2003 Annual Report, pg. 1).

What are some benefits of the Hassle Factor Log?
According to the Hassle Factor Log Program 2003 Annual Report, between the years of 2001 to 2003, average reimbursement rates reached as high as 57% of billable charges. This is the strongest direct benefit for the physician. But there are non-tangible qualities such as efficiency gains, lost revenues due to not seeing patients, and, often the most important benefit, TIME! Allowing the TMA staff to handle specific issues with insurance companies will free up your time so you can see more patients — this is a far more efficient process than dealing directly with the insurance companies.

How do I use the Hassle Factor Log?
TMA provides all the information needed to use this tool on its website: www.texmed.org. You also can contact TMA to have the information mailed or faxed to you.

Before using the Hassle Factor Log, you will need to sign the Business Associates Agreement. This is a standard, formal document that allows you to exchange protected health information with TMA within the parameters of the Health Insurance Portability and Accountability Act (HIPAA). After you sign this agreement, it is effective as long as you are a member in good standing.

There are a number of ways that Hassle Factor Logs can be submitted: electronically, by mail, or by fax. Electronic submission can be accessed through the physician portal on the TMA website. If a complaint is submitted electronically, supporting data will need to be faxed or mailed in as well.

Reasonable attempts must be exhausted before a Hassle Factor Log can be submitted. Collection attempts should be completed through the appeals process, and slow pay issues will not be considered until 45–60 days after claims submission. Records of these attempts or payment delays are considered “supporting data” and will need to be submitted with the Hassle Factor Log form. TMA will consider incomplete forms or forms without supporting data as informational only and will not take direct action to remedy the situation. Informational only claims are useful to help bring negative trends to the attention of the TMA Health Care Finance Department.

The Hassle Factor Log is the perfect means by which Texas physicians can voice issues and concerns about CMS and insurance companies to TMA. The Dallas County Medical Society strongly supports TMA’s successful physician advocacy programs.

The Texas Medical Association is the bullhorn through which your voice is heard; the Hassle Factor Log is the microphone through which you speak.

For more information about the Hassle Factor Log program, simply log on to the website, call the Health Care Finance Department directly at 512-370-1414, or call the TMA Knowledge Center at 800-880-7955.

To sign up to receive email updates on socioeconomic issues, contact Bryan White, director of Medical Economics and Quality at the Dallas County Medical Society: bryan@dallas-cms.org or 214-413-1444.