Re: Capitation
From: art fougner, md (evsono@pipeline.com)
Mon Jun 26 08:52:23 2000
sounds like we need to go back to that window again. alert your medical
society about this and anything else that bugs you. thanks for the
heads up.
art
At Mon, 26 Jun 2000, Dean Huffman wrote:
>
>That is what I do. But a lot of physicians are not even aware that they
>are being taken on this scam.
>
>At Sun, 25 Jun 2000, art fougner, md wrote:
>>
>>well then - now that you know this one - why not renegotiate? or leave
>>that plan? why do we feel obligated to live with this?
>>
>>art
>>
>>At Sat, 24 Jun 2000, Dean Huffman wrote:
>>>
>>>One of the bets tricks I have seen managed care companies do is to capitate
>>>patients for OB/GYN but not make the patient declare an OB/GYN until her
>>>first visit. Therefore it is possible for me to be responsible for a
>>>patient for a year or longer, but since she has never declared an OB/GYN
>>>physician until she finally has a visit, a pregnancy, or an emergency, the
>>>managed care company gets to keep the payments for the past year, whereas I
>>>get to assume the responsibility for that year.
>>>
>>>--
>>>Dean Huffman
>>>
>>>- - - -
>>>
>>>Capitation
>>>
>>>From: Pam Palmer (wapp88@gateway.net)
>>>Sun, 14 May 2000 20:53:41 -0500 (CDT)
>>>
>>>It has been my experience over the past several years dealing with a
>>>capitated carrier. Now, the carrier has decided to change the contract and
>>>now make this a fee for service contract.
>>>
>>>I know this should be good news, but we do not have the fee schedule yet,
>>>and I've been told its equal to medicare rates. The contract reads that
>>>once sign, they can alter the contract and not have approval. Also, the
>>>change effects the current patients that have been seen. We no longer are
>>>paid for the patients we've seen in the last 3 months. It will mean a loss
>>>of thousands of dollars.
>>>
>>>The carrier stated since we are up for renewal we have no choice but to
>>>sign or get out. We can't afford to get out but is there a way to fight the
>>>contract or the losses. The fact is this is 30% or more of our patient load.
>>>
>>>Do you have any advice or suggestion. My e-mail address is
>>>wapp88@gateway.net.
>>>
>>>Thank you!
>>>
>>--
>>art fougner, md
>>
>>A series of 1000 cases begins with but a single anecdote.
>>
--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
