Yet another unscripted example of a client successfully fighting the managed care companies for a better fee schedule. Verbatim:
I just followed your steps–letter to our patients with a
drop-dead date about 5-6 months ahead, encouraged them to call their
benefits people (this plan covers a lot of small unions; it’s really
just a claims priocessor, so getting the union members to protest was
the key), and waited for the call from [MCO] asking what would they
have to do to keep us. I made a proposal, asking for about 130%
Medicare. They initially came back that they couldn’t go that high, but
then proposed 100% of the N. NJ Medicare rates, which, as I said, are
at least 120% of ours. They could have countered with 100% of OUR
Medicare schedule, but, for some reason, they used the NJ one–to our
…we are having our front desk person call [the patients] to inform them that we are staying in the plan–and getting them
to schedule their next well visit at the same time.
I love it, especially that last line. Sure enough, the doc here ran a quick report and confirmed that it’s a 75 percent fee increase and is getting the kids in ASAP.
Big, conglomorate practice? No.
Professional negotiator? No.
Willingness to say, “No!” to an MCO? Yes. That’s what it takes.