Confessions of a Pediatric Management Consultant... Where fame and fortune await those who help keep pediatric practices alive and independent!

More "Whoops"

Written by Chip Hart | Oct 12, 2007 1:02:20 PM

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?"

You wonder?!