This educational resource was developed through a cooperative effort between the American Medical Association Practice Management Center and Topline Solutions Inc. , a subsidiary of NaviNet. Copyright 2008 – 2013 American Medical Association. All rights reserved.
Dealing with patients’ health insurers is often complex and frustrating for physicians and their practice staff. Navigating the maze of health insurer contracts and contending with medical payment and other reimbursement rules that differ from health insurer to health insurer demands significant administrative cost and time. After investing in expensive practice management systems and submitting claims to patients’ health insurers, physicians and their practice staff find that it can take weeks or even months to receive payment from these health insurers — if they receive payment at all. Health insurers also often change contracted r ates with little or no notice, which makes it difficult to audit payments for accuracy. On top of all this, many physicians have been unable to negotiate rates that are adequate to cover increasing practice costs, leaving them with the feeling that maintai ning the financial viability of their practices is beyond their control. Physicians seeking ways to simplify their practices and reduce administrative overhead are evaluating whether limiting their financial dependence on health insurer contracts is a viab le option. Many of these physicians are turning to an array of alternatives often referred to as “cash practices.”