Select Health of South Carolina is committed to providing quality care to its members. To assist with this effort, Select Health annually surveys our practitioner community to assess our strengths and opportunities in a variety of areas including overall provider satisfaction, claims reimbursement process, utilization management and provider relations representatives.
In our most recent survey, more than nine out of ten network providers indicated that they were "very satisfied" or "satisfied" with Select Health, a consistent response year after year. A summary of some of the results are noted below:
- Overall Provider Satisfaction - Overall, 92.4% of respondents replied that they were very satisfied or satisfied with Select Health. This compares to 92.7% in 2008. The vendor national average for overall satisfaction is 87.8%.
- Claims Reimbursement Process - Overall, 87.9% of respondents replied that they were very satisfied or satisfied with the claims reimbursement process. These components included ease of claims submission process, accuracy of claim payments, timeliness of claims payment, claims customer service knowledge, and timeliness of telephone response to our customer service line. Select Health continues to focus on even greater results by expanding and improving our claims reimbursement process to include electronic funds transfers and self-service options.
- Utilization Management (UM) - The UM process continues to excel with an overall satisfaction rate of 89.1%. This compares to a national average of 86.7% and includes rating elements such as ease of the referral and pre-authorization submission process and timeliness of UM decisions.
- Provider Relations Representatives - Provider Relations representatives also continue to receive high marks for provider satisfaction. The 2009 survey shows overall satisfaction at 91.8% of respondents. This compares to a vendor national average of 88.7%. Components of this category are accessibility, knowledge, timeliness of response, and problem resolution. Primary care providers assessed provider representatives at a slightly higher rate (95.5%) than did specialists (88.8%).
Select Health uses an outside vendor to conduct the survey with the plan's network of providers to determine their satisfaction with Select Health's services. The survey vendor uses a three-step methodology consisting of a questionnaire sent in two phases and then a telephone follow-up call for those providers who have not responded. A total of 1032 practices were surveyed with a response rate of 365 surveys returned or 35.4%. Of these returned surveys, 157 were primary care practices and 208 specialist practices.
The information we receive from the survey allows us to develop and improve internal business processes to better meet the needs and expectations of our provider network. Results from the survey are reviewed internally, and a listing of identified opportunities and planned actions are developed and presented to the plan's Total Quality Committee. We look forward to receiving responses to the next survey to ascertain if these interventions met the needs of our provider community. As always, we welcome input from our providers on offering superior customer service.