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medpundit |
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Wednesday, October 09, 2002When our practice found itself working harder and harder and our compensation kept spiraling out of control, we decided to take a long hard look at reimbursements from our payers, when we received a letter from our major insurer that we owed them some ridiculous amount of money in supposed overpayments. The first step in our process was to collect information. Frankly, we never got much further than this. As naive as we may have been, we thought that it would be educational to know whether what an insurance company had agreed to pay us, they were indeed paying us. At this point we realized that our fee schedules were woefully outdated. We attempted to obtain updated fee schedules from the insurance companies. Our largest insurer, basically refused to release their fee schedule. We had no way to know whether we were getting paid what we were owed. It took us about 10 months of legal action, tens of thousands of dollars, which we really couldn't afford, and lots of meeting time with lawyers and insurers, before they agreed to release the fee schedule in piecemeal fashion. They would only release 20 codes at a time. We also asked them for a detailed list of all the supposed overpayments that we owed them. They were unable to supply this. When we finally found out how little we were being paid for most of our procedures, significantly lower than Medicare in most circumstances, we attempted to renegotiate the contract. Basically, they then refused, stating that what we had been given was their fee schedule and they didn't negotiate. Take it or leave it! When our revenues finally equaled our expenses, and there was little left to take home for our families, we left it. posted by Sydney on 10/09/2002 08:19:00 AM 0 comments 0 Comments: |
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