With so many clinical restrictions in healthcare right now, physicians and their medical expertise might just become redundant unless something is done.
I was sitting here listening to a song from the early 1990s by Seal, and there was a line that struck a chord in me: "She wants us to be what's going on in her mind. If she is to take over, she must prevent unity."
We all feel it as healthcare providers, administrators, and support staff; insurance companies are yanking our strings like a marionette. It seems that all of the rules that are in our contracts are written to protect the insurance company's bottom line and not the provider's. If providers stand together and try to speak their minds to the insurance companies, it's considered collusion. So, the insurance companies always seem to have the upper hand, and we wait patiently to be paid for our services. Sometimes, we never see that money.
There are groups that you can join to help educate yourself and your colleagues about insurance companies, their "right-doings," and their "wrong-doings." This is a perfectly legal and acceptable means of communication and education. Here are a few places to start:
Regardless of which one you join, please consider joining an association you know will continue to fight for your practice.
Metaphorically, what insurance companies have done is line physicians and their practices up in a row with a small bag outstretched, allowing each of us only a small portion of what we've billed out in patient services. They are literally counting on physicians and their staff to accept the insurance companies' bad behavior as "the norm." It's like we've all been desensitized to their actions.
I often hear, "Because that's the way we've always done it." Well, I can tell you now that insurance companies are constantly changing their process and methods, and you need to keep up with what they are doing. By continuing to act in a very standardized, automated way, you are allowing the insurance company to take even more of your business' identity and profits away.
I'm not saying, "Don't follow your insurance contracts." That would be ludicrous. What I am saying is really understand what is written, and use that to your advantage. You are allowed to challenge an insurance company. If you think challenging them will land you on their bad side, don't worry, there are government agencies that can ensure you are safe in this area. If it does occur, you simply send in a complaint to the agency and let it do an investigation and fine the insurance plan if they are found culpable.
Between insurance companies continuing to reduce physician revenue and the pharmaceutical industry advertising to patients about potential diseases and problems they could have, so they'll tell their physician, its seems the physician has been pushed out of healthcare altogether. In an article written last week titled "Inbox: Fast Food Medicine" it's clear that physicians seem to be pushing a rock up a hill on a daily basis now. It used to be they were only fighting the insurance companies over what they would approve, and what they considered medical necessity. Now the problem has turned 180 degrees, and it seems the physician is no longer the expert in healthcare.
It's time for unity among the physician business owners. We need to take back what is rightfully ours.