Re: Re: Aetna turned my request down

[Guest guest]

I’m going to have to go in and see

what Aetna is paying us…..I know Anthem

is our worst payor (now that we don’t take Medi-Cal any more), but you

guys have my curiousity piqued.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of newfloc

Sent: Friday, November 26, 2010

9:18 PM

To:

Subject:

Re: Aetna turned my request down

I don't have much to offer. I sent a letter, got no

response. I called repeatedly, got no substantive response. I dropped them. I

still have a few patients with Aetna who stuck with me despite this, and I'm

still giving them the Aetna discount to thank them

for their loyalty.

Haresch

>

> I sent letters out to all the PPo that I take to ask to be paid the medicare

> rate. Aetna called and said no way. We

need to cut costs, employers wnat us

> to cut cost. I responded that their costs could be lower if we had better

> primary care and insurance co would support us. Without us, people get

sick

> and have to go to ER or call their dermatologist??? She laughed. Anyway

she

> says to write a letter comparing what they pay me for the codes i usually

> bill and the Medicare rate...any pointers from the group for my letter? I

> have not done HYH (got lost to follow up I think)

>

> --

> M.D.

> www.elainemd.com

> Office:

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> Go in the directions of your dreams and live the life you've imagined.

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>

>

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[Guest guest]

To our advantage, if most pt are going to have high deductables plans we can be out of network, charge a reasonable rate. Should be almost the same differerce for our pts and we don't get the insurance hassels. Is that too good to be true? I have a letter in mind. Show the amt paid by maedicare. Give example of how Primary care saves them $ and help their bottom line if we are strong and there really is no other way. Aetna did admit that they pay higher amt to larger groups. Any idea how we can get equal pay with the larger groups?

BTW - thank you so much for your support and advice thru out the yrs. It has saved me more than once. If you can some how charge a retainer fee, it sure would help. Luckily for me most solo practices around my area are either cash, conceirge or cash only. I don't charge pts over 65 yo, so no fear of medicare hassels.

Maybe Steve can find a niche that would help him raise above the crowd. I have been doing integrative medicine and acupuncture in addition to primary care. Pts really like it. Also I moonlight at urgent care (4hrs)  and teach (4hrs) a week. Both of those jobs I really like except the time away from family on weekend. It pays my rent

I am currently looking into re financing my business loan into my home mortgage becuase interest rate would almost be half- 7% to 4.5 %. My loan has my home as collateral anyway

 

I’m going to have to go in and see what Aetna is paying us…..I know Anthem is our worst payor (now that we don’t take Medi-Cal any more), but you guys have my curiousity piqued.

 

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From: [mailto: ] On Behalf Of newfloc

Sent: Friday, November 26, 2010 9:18 PMTo:

Subject: Re: Aetna turned my request down

 

 

I don't have much to offer. I sent a letter, got no response. I called repeatedly, got no substantive response. I dropped them. I still have a few patients with Aetna who stuck with me despite this, and I'm still giving them the Aetna discount to thank them for their loyalty.

Haresch>> I sent letters out to all the PPo that I take to ask to be paid the medicare

> rate. Aetna called and said no way. We need to cut costs, employers wnat us> to cut cost. I responded that their costs could be lower if we had better> primary care and insurance co would support us. Without us, people get sick

> and have to go to ER or call their dermatologist??? She laughed. Anyway she> says to write a letter comparing what they pay me for the codes i usually> bill and the Medicare rate...any pointers from the group for my letter? I

> have not done HYH (got lost to follow up I think)> > -- > M.D.> www.elainemd.com> Office: begin_of_the_skype_highlighting                    end_of_the_skype_highlighting

> Go in the directions of your dreams and live the life you've imagined.> This email transmission may contain protected and privileged, highly> confidential medical, Personal and Health Information (PHI) and/or legal

> information. The information is intended only for the use of the individual> or entity named above.> > > > If you are not the intended recipient of this material, you may not use,

> publish, discuss, disseminate or otherwise distribute it. If you are not the> intended recipient, or if you have received this transmission in error,> please notify the sender immediately and confidentially destroy the

> information that email in error.>

-- M.D.www.elainemd.comOffice: Go in the directions of your dreams and live the life you've imagined.

This email transmission may contain protected and privileged, highly confidential medical, Personal and Health Information (PHI) and/or legal information. The information is intended only for the use of the individual or entity named above.

 If you are not the intended recipient of this material, you may not use, publish, discuss, disseminate or otherwise distribute it. If you are not the intended recipient, or if you have received this transmission in error, please notify the sender immediately and confidentially destroy the information that email in error.