Dropping Delta

  • Posted by Matt Pitts on March 27, 2024 at 9:51 am

    We started a program to remove PPO participation from our practice. We started with United Concordia and Cigna as a practice run. The rest, including Delta, we are going out of network with by years end. It is our understanding that once we go out of network, then Delta will begin sending checks to the paients instead of the EFT’s we get now. This creates either a collections nightmare for us, or a serious barrier to accepting treatment for a lot of patients. Is there a good protocol for treating patients for whom insurance checks are sent to the patient and not your practice other than making them pay the full amount up front?

    Missy Pollard replied 3 months, 2 weeks ago 2 Members · 1 Reply
  • 1 Reply
  • Missy Pollard

    Organizer
    March 29, 2024 at 2:50 pm

    CONGRATULATIONS on taking the steps to go out of network! I don’t think it needs to be complicated. Be up front with patients about why you are making this change and explain what this looks like for them moving forward. If you are concerned about patients not accepting treatment because of the cost, you can provide financial relief options like CareCredit, or you can split their payments – half at scheduling and the remainder on the day of treatment. When patients understand the reasoning behind a change like this, they will be fine. You want to be able to provide an exceptional standard of care and you cannot do that as an in network provider. So, they will be getting the care they need and utilizing the benefits they pay for; The only change is they will pay at the time of service and then be reimbursed directly. Make sure your team has the proper verbiage for explaining the process. I hope this helps! If you want to discuss this further, feel free to send me an email to [email protected] and we can continue the conversation.

Log in to reply.