News & Articles


By Leigh Perry

I have been working in the industry for almost 20 years. I remember a time when an anesthesiologist could send in a bill for what you thought was a fair market amount, wait two months at the absolute most and get a check from the insurance with little or no hassles. I remember the days when any reputable doctor could provide a service and get paid directly for it. I remember a time when a patient could come into a doctor's office, present their insurance card and have a service performed on the same day and be done with it. Those days are gone!

Nowadays it feels like everybody, except the insurance carrier's CEO, has to jump through hoops and bend over backwards until their foreheads meet their heels, just to get a claim accepted by insurances. As for fair, equitable and timely payments, well that's another story and a frustrating one at times.

Honestly, I feel like sending the billing universe a message in a bottle. It would read something like this:

Help! They're trying to force me to participate!

The other day I received a phone call from Aetna asking me if I wanted to participate. They offered a ridiculously low fee which I, of course, rejected. The rep was not very happy and reminded me that Aetna will be instituting a new policy which will cause all non participating provider payments to go directly to the member. I didn't flinch. I told the rep that I knew they had considered this before and changed their minds because they knew their members would complain about it. I told her that I have been doing this dance for many years and I would not be intimidated. I suggested a compromise of a contract fee half way between what they wanted to give me and what I have been getting from them. She refused. End of round one!

The way I see it, insurance companies have come to believe that we are at their mercy - (well sometime we are, but not always). They offer to pay us a pittance for the privilege of waiting around until they decide to pay us, and since we have a contract, we can't bill their members. So they play the cat-and-mouse game with us, mess up our payments, say they are sorry and keep on treating us badly. Well I for one refuse to be so basely taken advantage of by these multimillion dollar companies and their silver spoon CEO's. I refuse to sit on the ropes, be nice and smile and say please and thank you while they pummel my back. I know who has the glass jaw.


Now I do par with a few places like GHI and Local 1199, because experience has shown that this is the better way. Some of my clients prefer to par with several other carriers for their own reasons. But for the most part, I have managed not to let these carriers strong arm me into making millions off of my clients' backs.

I will continue to do my best to thwart the evil carriers' plans of world domination. Sometimes I wonder if I should get a shirt with a big red B on it, a cape, and a jet pack and go flying off to Washington, but I just can't be in two places at once. I am fortunate to have "people" who have been going to Washington and doing wonderful things there as well. The fight will continue.

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