Not enough terrorist to spy on? Apparently not. The Obama administration is planning a stealth survey of physicians to see if doctors give different answers to callers depending on whether they have public insurance, like Medicaid, or private insurance, like Blue Cross and Blue Shield.
Federal officials provided this example of a script for a caller in a managed care plan known as a preferred provider organization, or P.P.O.:
Mystery shopper: “Hi, my name is Alexis Jackson, and I’m calling to schedule the next available appointment with Dr. Michael Krane. I am a new patient with a P.P.O. from Aetna. I just moved to the area and don’t yet have a primary doctor, but I need to be seen as soon as possible.”
Doctor’s office: “What type of problem are you experiencing?”
Mystery shopper: “I’ve had a cough for the last two weeks, and now I’m running a fever. I’ve been coughing up thick greenish mucus that has some blood in it, and I’m a little short of breath.”
In separate interviews, several doctors said that patients with those symptoms should immediately see a doctor because the symptoms could indicate pneumonia, lung cancer or a blood clot in the lungs.
Other mystery shoppers will try to schedule appointments for routine care, like an annual checkup for an adult or a sports physical for a high school athlete.
To make sure they are not detected, secret shoppers will hide their telephone numbers by blocking caller ID information. Eleven percent of the survey will receive a third call where the caller will identify himself as an employee of Health and Human Services and check for answers different those given the spy callers. More
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