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2010 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 5/1/09 and 5/31/10.  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.

The below percentages are Summary Rate Scores based on the two most favorable response options:

Question 2010
PCP
2010
SCP
2010
Hospital
2010
Ancillary
Continuity and Coordination of Care
PCPs Only-Receipt of Appropriate Documentation received from Specialty Care Practitioners 83.9% N/A N/A N/A
PCPs Only-Receipt of Appropriate Documentation received from Hospitals 87.3% N/A N/A N/A
PCPs Only-Receipt of Appropriate Documentation received from Skilled Nursing Facilities 70.2% N/A N/A N/A
PCPs Only-Receipt of Appropriate Documentation received from Home Health Agencies 95.3% N/A N/A N/A
Gateway Representative and Communication
Professionalism and Courtesy of your Gateway Provider Relations Representative 95.5% 90.9% 80.0% 88.5%
Timeliness of the Gateway Provider Relations Representative when responding to inquiries 94.0% 88.3% 90.0% 86.3%
Knowledge of the Provider Relations Representative regarding Gateway’s Policies and Procedures 96.1% 90.6% 85.0% 85.7%
Your Overall Satisfaction with the Quality of Service from your Gateway Provider Relations Representative 94.2% 88.8% 90.0% 81.2%
Quality of Written Communications, Policy Bulletins, and Manuals 96.2% 89.5% 94.4% 84.8%
Do you find written communications useful? 92.1% 93.3% 73.3% 93.4%
Provider Services and Claims
Consistency of Provider Services Representatives’ Answers to Inquiries 95.8% 88.2% 82.4% 84.4%
The Knowledge of the Provider Services Representative regarding Gateway’s Policies and Procedures 95.8% 87.9% 83.3% 84.6%
The Professionalism and Courtesy of the Provider Servicing Representative 95.9% 89.4% 88.9% 86.3%
Timeliness of Provider Servicing Staff when Responding to Inquiries 95.2% 85.9% 77.8% 83.9%
Your Satisfaction with Clean Claims being Processed Consistently 90.7% 86.8% 73.3% 79.4%
Your Satisfaction with Clean Claims being Paid in a Timely Manner 92.0% 90.3% 85.7% 81.5%
Your Overall Satisfaction with the Claims Review Process 87.6% 79.1% 64.7% 70.1%
Utilization Management
Your Knowledge of which Services Require an Authorization 94.8% 86.0% 100.0% 80.7%
Timeliness of UM Staff when Responding to Inquiries 90.1% 89.1% 78.6% 86.2%
UM Staff’s Clinical Knowledge 94.0% 89.7% 92.3% 89.3%
UM Staff’s Consistency in the Authorization Process 90.8% 89.3% 84.6% 87.3%
Medical Appropriateness of Gateway’s Physician Reviewer Decisions 85.2% 80.9% 72.7% 88.5%
Professionalism/Courtesy of the UM Staff Representative 94.7% 93.1% 83.3% 90.8%
Your Overall Satisfaction with the UM Process 91.2% 88.1% 75.0% 89.3%
Your Knowledge of which Services Require a Referral 96.8% 87.6% 91.7% 74.8%
The Ease of Use/Completion of the Paper Referral Form 95.2% 83.6% N/A N/A
Pharmacy Authorization Process, Staff, and Drug Formulary
When Calling Gateway’s Pharmacy Department, Pharmacy Staff’s Professionalism and Courtesy 89.7% 93.1% 100% 90.0%
When Calling Gateway’s Pharmacy Department, Pharmacy Staff’s Consistency in Responses Regarding Formulary Procedures 90.5% 89.2% 0.0% 85.0%
When Calling Gateway’s Pharmacy Department, Pharmacy Staff’s Timeliness when Responding to Inquiries 88.6% 91.0% 0.0% 85.0%
Your Understanding of the Gateway Pharmacy Authorization Process 92.8% 85.0% 0.0% 85.7%
Your Overall Satisfaction with the Gateway Pharmacy Authorization Process 85.6% 86.6% 100% 90.0%
Ease of Using Gateway’s Web-based and Personal Digital Assistant (PDA) Drug Formulary 83.8% 79.6% 0.0% 90.0%
Variety of Drugs Available on Gateway’s Drug Formulary 74.5% 67.2% 50.0% 61.1%
Disease Management
Practice Benefits from the Asthma Disease Management Program 83.0% 54.5% N/A N/A
Practice Benefits from the Diabetes Disease Management Program 87.2% 76.9% N/A N/A
Practice Benefits from the Cardiac Disease Management Program 82.5% 86.4% N/A N/A
Practice Benefits from the MOM MattersSM High Risk Maternity Program 81.4% 87.0% N/A N/A
Practice Benefits from the Complex Case Management Program 86.7% 65.0% N/A N/A
EPSDT Services
If you Conduct EPSDT Screens in your Office, Your Overall Satisfaction with the EPSDT Screening Program 83.5% N/A N/A N/A
Accessibility
Routine Appointments Scheduled in less than 10 Business Days 72.3% 71.1% N/A N/A
Urgent Care Appointments Scheduled within 24 Hours 98.1% 74.6% N/A N/A
Wait Time in the Waiting Room no Longer than 30 Minutes 65.8% 62.5% N/A N/A
Hours of Availability
Provider Relations Hours of Operation Meet Practice Needs 95.3% 95.9% 88.9% 86.9%
Provider Services Hours of Operation Meet Practice Needs 92.4% 97.0% 94.4% 93.8%
Utilization Management Hours of Operation Meet Practice Needs 93.5% 95.6% 77.8% 93.8%
Pharmacy Department Hours of Operation Meet Practice Needs 92.5% 96.4% 100% 89.5%
Overall Satisfaction and Loyalty
Consistency Across all Departments at Gateway 96.6% 96.7% 80.0% 94.8%
Would you Recommend Gateway Health Plan® to other Physicians’ Practices 95.4% 92.4% N/A N/A
Overall Satisfaction with Gateway Health Plan® 93.8% 86.2% 87.5% 83.2%
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Last Updated: 4/6/2011