Recently, I shared an example of insurance company shenanigans reported to me by a customer. Since then, I’ve seen at least two or three other examples on places like the “Financial Management Society” MGMA mailing list, etc.
So, here’s another subtle one – and it’s subtle, only because it happens so often that people don’t remark about it – from a customer. In this instance, the MCO is one of the “good ones” (generally speaking) and has made a more-fair-than-usual offer. But examine this exchange in the middle of the negotiation process:
Customer: Here are the CPT codes for which I want a special rate. Please give me the fees for them.
[Three weeks pass]
MCO: Here they are! Just sign the contract and we’re done!
Customer: Um, these are the very same prices you give to everyone. This isn’t a special contract, it’s your generic one. What’s up with that?
[Three weeks pass. No admission of mistake.]
MCO: Here are your new prices.
Customer: Whew, good thing I read my contracts.
Someone on the MGMA list asked out loud, “Boy, I used to just think these poor reps were over worked, but now I wonder if it’s deliberate?”