Established Versus New

October 1, 2007

Generally speaking, I assume that I cannot refuse new patients with a particular payer if I am going to continue to see established patients within the same plan/insurance. Is that correct?

Question: Generally speaking, I assume that I cannot refuse new patients with a particular payer if I am going to continue to see established patients within the same plan/insurance. Is that correct?

Answer: Generally speaking, yes. Payer contracts usually require you to see both kinds of patients and to provide a modicum of access to their beneficiaries.

Moreover, you want new patients since established ones will go away for various reasons, and new-patient visits pay better.