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Do You Have Holes In Your Reimbursement Bucket? The “Public Option” May Make Those Holes Bigger

Most medical providers have holes in their Reimbursement Bucket. Silent PPO reductions, UCR rate reductions, managed care contract underpayments. With the current push from the White House for a "public option" as part of health care reform, private insurance companies may finally have to compete on premium rates. What happens when private insurance companies have to reduce rates because of legitimate competition? They increase the illegitimate reductions and denials of claims to offset the loss of premium dollars.

If you have holes in your Reimbursement Bucket you may see them get a lot bigger with health care reform as insurance companies try to exploit the medical providers who are not diligently monitoring their reimbursements. Health insurers will get even more aggressive on costly out-of-network claims and will aggressively pursue Silent PPO discounting and other denial and reduction practices. Your practice needs to plug the holes in your reimbursement bucket now and recoup lost receivables where possible. Contact Philllips & Garcia, P.C. to discuss strategies for increasing reimbursements on denied and reduced claims.

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