Managed Care Contract Negotiations
Aug 24

Physicians out of network – checks going to the patient

A client recently received a letter from Unitedhealthcare stating that effective Sept 1, "…we are making changes in the way we direct claims payments for services rendered by non-network care providers and facilities. ….UH will pay commercial members directly for services upon receipt of the claim".

This policy is becoming more prevalent around the country – sending payments directly to the patient instead of to the medical practice – Just another way managed care payers are trying to force physicians to become in-network providers.

This will put even more pressure on physician practices to collect more monies up front from the patient, either full payment, partial payment, or some type of "down payment." So make sure the office has a collection policy in place to deal with this situation, make sure office personnel are properly trained, and MONITOR to make sure the collection policy is being adhered to and is successful.

About Reed Tinsley, CPA

As a top advisor to physicians, I help increase practice profits by delivering hands-on, expert medical accounting/tax support, practice counsel, and revenue-building strategies. Read more →