There has been a flurry of activity and tons of questions surrounding one of the latest deceptive tactics of some cheeseball insurance payers who apparently aren’t content with stealing your money legally via their contract. In this latest scheme, payers are attempting to fool you into giving them even more money. What's worse is that the tricks are going viral and being waged by a number of payers all over the country.
Apparently, since there are so few providers in-network with the plans offered through the health insurance exchanges (i.e. Obamacare plans), payers are beginning to push legal boundaries in an attempt to get chiropractors (and other physicians) to sign up for their lousy plans.
The “Update Your Records” Sucker Punch
Chiropractic offices across the country have started to receive faxed forms that are requesting you to “update your records."
The problem is that the forms act as a contract and upon signing them and faxing them back, practices are stating that they will see patients at a VERY reduced rate than what they are accustomed to receiving. It’s especially difficult to navigate because many of the Exchange plans are run by the same payers who also offer traditional PPO plans. Unfortunately, the rates may be extremely different (as are the patient benefits).
As a result, the “records update” becomes a dangerous tool in the payer’s hand. Worse, it is highly likely to get past many a well-meaning front desk CA who will do anything they can to help you out and take care of distracting paperwork.
The Home Credentialing Scheme
As if the “records update” wasn’t bad enough, some payers are also resorting to another scheme: mailing a “credentialing contract” directly to your house.
Initially, you might not think of anything alarming from this, as payers routinely require re-credentialing. The tip-off is the fact that those documents are almost always sent directly to your practice address (or practice mailing address where checks are sent) – not your home.
Unfortunately, just like your helpful front-office staff, unaware doctors may to help out the staff by filling in the required information and mailing or faxing the form back to the insurance company. In the meantime, they could be sealing their doom and locking in low contractual rates for plans they didn’t want any part of.
ACTION STEPS
Inform staff to be very suspicious of any “records” or “information” updates – especially if these arrive via fax.
Always have staff members check plan benefits, the contract and the fee schedule before joining or re-credentialing with any plan. Additionally, it may be helpful to check employer groups or plan size if you’ve never heard of the plan – why join if they don’t have many patients to send you?!
Ignore any requests via fax to sign contracts of any kind. These could be phishing scams or just plan bad moves.
