Fighting back when Defendant Insurance
demands you “accept” patient’s managed
care rates---even when you don’t bill them
THE PLOY
When the defendant’s carrier sends you letter that after ‘reviewing’ your bill, they will either deny or dramatically reduce your bill. They argue since you are ‘contracted’ with the patient’s manage care company – you are obligated to ‘accept’ its contracted rates. Adding insult, you are further reminded that balance billing is prohibited by your contract.
THE SOLUTION
Most managed care contracts would support the 3rd party car insurance ploy ONLY if the doctor elects to bill that contracted managed care carrier.
For an easy to follow form, listing 4 key arguments -- email johntawlian@shawnsteel.com
CA’s Most Dangerous Drivers are Unlicensed---says DMV
Of some 26 million drivers in California, some 2 million do not have a valid driver’s license.
Largest portion of unlicensed drivers in fatal accidents are between 20 and 29 years old. These figures are mostly illegal immigrants but include drivers who licenses are revoked.
Another powerful reason to encourage your patients to buy at least $100,000 in UM coverage and $ 5,000 in med pay. Generally in most of California those premiums will not exceed $10.00 a month.
Westin Hotel LAX
8 AM – 5 PM
“Best Defense is A Strong Case:
Advanced PI Extravaganza”
Submitted to the board
for 8 hrs of CE credit
PI Team: Sam Collins, Gary Lewkovich,
Shawn Steel
& Brilliant Neurosurgeon
3 areas are noted here. But most major cities keep computerized tracks of dangerous intersections. You may want to post one of the sites in your waiting room. Your patients would like know.
San Francisco’s site keeps track of pedestrians or cyclists who get severely hurt or die. This information comes from CHP records. Be careful on Masonic between Fulton and Haight. Then look carefully at Octavia and Market.
Walkers in Los Angeles have more accidents than anywhere. How about 817 intersections? Particularly dangerous are downtown, Koreatown and Hollywood. No surprise that insurance rates are quite high there.
