Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Thursday, July 31, 2014


If you read my post, Why would I do that?, you'll learn that I've been puzzled about an insurance phenomenon. I get these faxes from insurance companies, asking me to agree to an expedited fee for my services. For example, if the patient has submitted my bill for $300, the insurance company will suggest I accept $186. In addition, my signature on the form indicates that not only will I accept that amount, but I agree not to bill the patient for the difference.

I also get phone calls from the company asking me to call back and "negotiate" a fee, meaning I'll agree to accept less than my actual fee.

I could never understand how this constitutes a negotiation, since the insurance company is saying, "If you accept this amount, in exchange, we'll give you absolutely nothing. Would you like to be paid $300, or $186 for the same service?"

Hence the title, "Why would I do that?"

I think I've figured out why they think I would do that. In my disgust with these forms, I seem to have missed 2 key points.
1. The claim that this is a "time sensitive document." I assumed that was just an attempt to get me to sign it without thinking. And
2. the line, "Provider agrees to accept the above, provided that payment is released within 10 business days from date of receipt of faxed/digital signature."

It seems what they're offering in exchange for a lower fee is quick payment. I'm guessing this means that my lack of signature/agreement indicates my willingness to wait around indefinitely for my payment, if it's sent directly to me, or for my patient to wait around for his reimbursement.

So once again, the insurance company wins. Either they have to pay me quickly, but much less than my actual fee, or they can pay me whenever they feel like it, with all the snags and wrenches that can be encountered along the way, in order to delay payment.

It also tells me that the insurance company is more than capable of paying in a timely manner, but they consider themselves exempt from any such reasonable behavior. What do they do if a client is chronically several months late in paying her premiums?