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Doctors must wait for Medicare payments

In an effort to save money, the Clinton administration is slowing the payment of Medicare claims submitted by doctors, hospitals and other health care providers, according to federal officials and government documents.

The government has also ordered insurance companies that review and pay Medicare claims on behalf of the government to send fewer notices to beneficiaries and to make greater use of telephone voice mail to answer inquiries from doctors checking the status of unpaid claims.

These steps illustrate fiscal problems at the Medicare agency, which provides health care for 38-million people who are elderly or disabled. The volume of claims has soared in recent years, but the budget for reviewing and paying claims has changed little. At the same time, the agency has been swamped with new duties and responsibilities as a result of several laws passed by Congress in the last few years.

Doctors and insurers said the effects of the changes were already being felt. United Health Care, a Medicare contractor that pays claims in Virginia, Connecticut, Minnesota and Mississippi, said that under the new policy, doctors may have to wait up to 20 days for payment of electronic claims, six days more than in the past.

Even before the government told Medicare contractors to change their payment cycles, doctors in some parts of the country were complaining of delays. Robert L. Dernedde, executive director of the Oregon Medical Association, said doctors there had documented "a whole raft of unpaid claims."