Insurance Companies Short-Changing Therapists


I don’t like to see our profession getting ripped-off. It’s bad enough that reimbursements are being cut and we are being told our procedures and modalities don’t have any value anymore (ie. cryotherapy, electrical stimulation, etc.). Now, to add more cut to the crime they are using underhanded tactics to further rip us off.

HERE ARE TWO WAYS insurance companies are short-changing healthcare providers:

1) Paying with plastic and virtual credit cards. There are fees associated with the processing of these cards and you end up footing the bill. Learn more.

2) Flat out being dishonest. More and more physical therapy practices are being paid less than the agreed upon rate that’s stipulated in the written contract. If you don’t know your contracted rates with each of your insurance plans, you are probably getting ripped-off. Check your next EOB’s and reimbursement checks. Are they paying what is agreed upon in your contract? Many are not. And the CEO’s are lapping them up for more big profits.

Here’s what you do:

1) Write a letter to the payers that are issuing plastic or virtual credit cards and request to be paid by another method. It is your right. If they deny your first request, don’t give up. Write an appeal and “Cc” the your local congressperson along with insurance commissioner in your state.

2) Find out your contracted rates with each insurance payer. If you don’t know, find out. Make an excel spreadsheet that lists all your contracted rates (see below). Display it at your front desk and charting station. Check the EOB’s and make sure they are paying what is agreed upon. You might be surprised. If you are being short-changed, fax a letter asap before depositing the check. I recommend you take the “Advanced Billing Course” by IndeFree that’s coming up soon but if you need a sample letter in the meantime just contact me.

Sample Chart of Contracted Rates



What do you think of the tactics used by insurance companies? Share in comments below.

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James Ko

I believe... "It's not the strongest practices that survive and grow, nor the most intelligent, but the ones most adaptable to change." I'm a physical therapist, private practice owner, and founder of IndeFree Association. I like reading James Patterson, Nicholas Sparks, enjoy golfing and playing guitar. I love playing with Mac and Cozy! For over 15 years, I've helped thousands of practices grow and succeed. This is my dedication.

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