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2009 Practitioner and Provider Satisfaction Survey Results

The population sampled included primary care practitioners with a panel size of 100 members or greater. The specialty care practitioners sample included high-volume specialists with at least 5 unique member visits and paid claims with a date of service between 5/1/08 and 5/31/09. 100 % of the hospital network and a remaining sample of ancillary providers were also surveyed.

Gateway will continue to strive toward meeting the needs of our practitioner and provider network. Action plans are developed to improve those areas with deficiencies to assure ongoing improvement.

Question 2009
PCP
2009
SCP
2009
Hospital
2009
Ancillary
Continuity and Coordination of Care
PCPs Only-Receipt of Appropriate Documentation received from Specialty Care Practitioners 88.5% N/A N/A N/A
PCPs Only-Receipt of Appropriate Documentation received from Hospitals 88.4% N/A N/A N/A
PCPs Only-Receipt of Appropriate Documentation received from Skilled Nursing Facilities 80.9% N/A N/A N/A
PCPs Only-Receipt of Appropriate Documentation received from Home Health Agencies 95.8% N/A N/A N/A
Gateway Representative and Communication
Professionalism and Courtesy of your Gateway Provider Relations Representative 96.5% 92.7% 90.0% 92.1%
Timeliness of the Gateway Provider Relations Representative when responding to inquiries 94.5% 88.1% 71.4% 85.3%
Knowledge of the Provider Relations Representative regarding Gateway’s Policies and Procedures 97.0% 91.7% 76.2% 88.1%
Your Overall Satisfaction with the Quality of Service from your Gateway Provider Relations Representative 93.8% 88.6% 76.2% 88.3%
Quality of Written Communications, Policy Bulletins, and Manuals 95.0% 92.9% 90.9% 83.9%
Do you find written communications useful? 91.3% 92.7% 100% 91.1%
Provider Services and Claims
Consistency of Provider Services Representatives’ Answers to Inquiries 97.8% 86.2% 73.9% 88.6%
The Knowledge of the Provider Services Representative regarding Gateway’s Policies and Procedures 97.9% 89.7% 86.4% 89.0%
The Professionalism and Courtesy of the Provider Servicing Representative 95.3% 91.4% 77.3% 93.8%
Timeliness of Provider Servicing Staff when Responding to Inquiries 94.1% 87.8% 82.6% 87.3%
Your Satisfaction with Clean Claims being Processed Consistently 94.8% 88.2% 81.8% 83.9%
Your Satisfaction with Clean Claims being Paid in a Timely Manner 92.3% 86.6% 95.0% 85.4%
Your Overall Satisfaction with the Claims Review Process 90.3% 83.2% 91.3% 77.5%
Utilization Management
Your Knowledge of which Services Require an Authorization 95.1% 91.9% 90.5% 86.5%
Timeliness of UM Staff when Responding to Inquiries 91.3% 88.8% 90.5% 87.7%
UM Staff’s Clinical Knowledge 93.9% 90.5% 95.5% 91.0%
UM Staff’s Consistency in the Authorization Process 94.4% 91.6% 95.2% 87.7%
Medical Appropriateness of Gateway’s Physician Reviewer Decisions 86.4% 82.5% 80.0% 83.8%
Professionalism/Courtesy of the UM Staff Representative 97.5% 93.8% 95.5% 94.5%
Your Overall Satisfaction with the UM Process 93.4% 88.7% 90.5% 89.7%
Your Knowledge of which Services Require a Referral 96.1% 89.6% 85.0% 78.2%
The Ease of Use/Completion of the Paper Referral Form 96.5% 84.3% N/A N/A
Pharmacy Authorization Process, Staff, and Drug Formulary
When Calling Gateway’s Pharmacy Department, Pharmacy Staff’s Professionalism and Courtesy 95.5% 91.7% 100% 95.7%
When Calling Gateway’s Pharmacy Department, Pharmacy Staff’s Consistency in Responses Regarding Formulary Procedures 94.2% 91.9% 100% 84.2%
When Calling Gateway’s Pharmacy Department, Pharmacy Staff’s Timeliness when Responding to Inquiries 93.1% 90.3% 100% 85.0%
Your Understanding of the Gateway Pharmacy Authorization Process 94.9% 86.7% 100% 80.0%
Your Overall Satisfaction with the Gateway Pharmacy Authorization Process 87.4% 87.8% 100% 81.0%
Ease of Using Gateway’s Web-based and Personal Digital Assistant (PDA) Drug Formulary 88.1% 85.8% 0.0% 85.7%
Variety of Drugs Available on Gateway’s Drug Formulary 67.4% 70.8% 50.0% 75.0%
Disease Management
Practice Benefits from the Asthma Disease Management Program 84.4% 69.4% N/A N/A
Practice Benefits from the Diabetes Disease Management Program 85.4% 81.8% N/A N/A
Practice Benefits from the Cardiac Disease Management Program 86.9% 78.3% N/A N/A
Practice Benefits from the MOM MattersSM High Risk Maternity Program 83.0% 80.8% N/A N/A
Practice Benefits from the Complex Case Management Program 83.5% 78.4% N/A N/A
EPSDT Services
If you Conduct EPSDT Screens in your Office, Your Overall Satisfaction with the EPSDT Screening Program 86.2% 88.6% N/A N/A
Accessibility
Routine Appointments Scheduled in less than 10 Business Days 67.5% 71.5% N/A N/A
Urgent Care Appointments Scheduled within 24 Hours 94.7% 79.0% N/A N/A
Wait Time in the Waiting Room no Longer than 15 Minutes 68.6% 55.7% N/A N/A
Hours of Availability
Provider Relations Hours of Operation Meet Practice Needs 96.9% 95.7% 100% 91.9%
Provider Services Hours of Operation Meet Practice Needs 96.7% 96.2% 100% 96.8%
Utilization Management Hours of Operation Meet Practice Needs 94.7% 96.9% 100% 94.3%
Pharmacy Department Hours of Operation Meet Practice Needs 96.1% 96.1% 100% 83.3%
Overall Satisfaction and Loyalty
Consistency Across all Departments at Gateway 99.0% 96.8% 90.5% 96.6%
Would you Recommend Gateway Health Plan® to other Physicians’ Practices 92.0% 89.6% N/A N/A
Overall Satisfaction with Gateway Health Plan® 94.8% 89.7% 75.0% 85.0%
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Last Updated: 1/1/2010