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Insurance Contracting is a Scam

Insurance Contracting is a Scam

Physicians agree to take discounts in exchange to get referrals from insurance companies. What they don't tell you is how they make it extremely difficult to get paid.

Many of the things we do in medicine aren’t to help the patient. And some of the things that we want to do help our patients we aren’t allowed to do. It isn’t the government legally stopping us, states are usually hesitant to pass any laws that say what a doctor can and cannot do. Mostly all of the regulations come in the form of holding reimbursements.

Doctor, if you don’t do A,B,C,D, and E, then we might not pay you the rate that you contracted with us.

 

Doctor, if you don't do A,B,C,D, and E, then we might not pay you the rate that you contracted with us. #medtwitter #MEDed #healthcare Click To Tweet

 

 

Do you remember the six month process that we made you go through so you could be in our network?

Do you remember that you agreed to take a price decrease to see our patients?

 

What they don’t tell you is that they make it extremely difficult for you to get paid.

They add hoops and more hoops.

This requires you to hire hoop jumpers to satisfy the rules of the game that they can and do change. You can’t succeed when you don’t make the rules.

 

This requires you to hire hoop jumpers to satisfy the rules of the game that they can and do change. You can't succeed when you don't make the rules. #medtwitter Click To Tweet

 

All of this madness leads to high volume practices where the patient gets only a handful of minutes with the doctor, and more time is spent “charting” (billing) than actually trying to deliver quality of care.

The irony of the whole situation is that if physicians stopped contracting with insurance companies, things would change rapidly. A lot of physicians are so institutionalized that when you tell them they need to drop insurance they laugh at you, or say they wish they could.

They can, many have, many more are doing it.

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Sherita D. Gaskins-Tillett, MD

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