Posted in Access to healthcare, Affordable Care Act (ObamaCare), Consumer-Driven Health Care, Crony Capitalism, Defined Contribution Benefit Plans, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Free-Market, Government Regulations, Health Insurance, Independent Physicians, Individual Mandate, Influence peddling, Medical Costs, Medical Practice Models, Patient Choice, Policy Issues, Pre-existing Conditions, Price Tansparency, Risk Adjustment, Risk Corridors, Self-Insured Companies, Tax Policy, Third-Party Free Practices, Uncategorized

Fair-Healthcare Zones: No Third-Party Contracts Permitted! | Robert Nelson, MD | LinkedIn

third-party-insurance-quote-m5uykrfyBut these government-given advantages enjoyed by the health plan networks are just the icing on the cake compared to the fact that these network health plans utilize strictly defined benefits that rely on a totally separate provider contract that must be in force in order to use those “benefits” (really mostly pre-paid health maintenance plan that is heavily restricted)!

And, to make matters even more economically perverse, a non-negotiable cumbersome and expensive “claims” process is required by the payer and must be filed by the provider for each encounter used by a subscriber, no matter how minor or inexpensive. It is only after the properly documented and coded “claim” has been filed with the payer that the doctor gets paid.

Read the entire article at Fair-Healthcare Zones: No Third-Party Contracts Permitted! | Robert Nelson, MD | LinkedIn.

Author:

A primary care physician by training, my passion is researching and writing about the importance restoring patient centered care, supporting independent private physicians, promoting free-market solutions and seeking sustainable fiscal policy in healthcare.

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