Paraphrased from a customer message on our client-only mailing list today:
I was wondering what you think of Coventry Health/Health First. I guess they have replaced old Health Care Value Management. We have been noticing that since Coventry has replaced HCVM their reimbursement has been ridiculously low… I called him and complained. Someone called back today and asked, “Why should we increase our rates if you don’t ask us to?” Anyway they are open to negotiating the rates and are offering me XXX% of the Medicare fee schedule. What do you all think?
What do I think? I think the insurance rep is right. They do run a business. And if you don’t run your practice like a business, why should they run it for you? Every day, millions of dollars go right into pockets of insurance executives from contracts that haven’t been examined, reviewed, or poked at in months or years.
For all the blame I have for insurance companies, a huge portion of the lack of proper payments for pediatricians is due to the pediatricians themselves.
God helps practices that help themselves. If you don’t demand proper payments, you won’t get them. I told this practice to sign immediately and give them the expectation that it will be reviewed every year!