Courtesy of Digital Journal
JANUARY 13, 2014 – Expert speaker Wayne J. Miller, Esq. will discuss the current limitations on a concierge practice and how it is still feasible under Obamacare in this informative session on Thursday, January 16, 2014.
Take a look at the topics covered:
- Comprehend the concierge and cash practice structures that pass legal muster
- Identify the covered services in exchange plans that impact cash arrangements
- Can you be both in and out of network?
- Know the insurance plan provisions that can trip up retainer practices
- Permissible financial arrangements with patients
- How and when to opt out of Medicare fee for service provider status
- Health plan licensing and other state law hurdles
For more information, http://www.audioeducator.com/medical-coding-billing/retainer-practice-01-16-14.html
Know The Current Limitations On A Concierge Practice
As exchange plans continue limiting provider networks and ramp down compensation, it’s not surprising that more professionals are exploring or pursuing different options. Some physicians are conducting a concierge or retainer practice that offers upgrades to cash-paying patients. Some have decided to “opt out” completely out of insurance programs. Others continue to participate in governmental and managed care arrangements, but are considering whether going “out of network” makes more sense financially and operationally, than remaining network providers. Still other professionals may adopt multiple approaches.
The Affordable Care Act has imposed new requirements that impact the ability to accept and charge patients for concierge service, if they also participate in exchange plans or in Medicare and traditional commercial plans. The ACA defines services that are “covered” in exchange and other plans. The law also requires every citizen to obtain insurance, meaning that many “cash” patients will in the future be covered.
Providers who seek to “opt out” have to follow a set of procedures to extricate themselves from Medicare or managed care plans. They will need to enter into agreements with Medicare patients regarding future care. Further, payer requirements and state laws also impose limits on doctors or groups establishing a cash or concierge practice.
In this 60 minute session, expert speaker Wayne J. Miller, Esq. will discuss the current limitations on a concierge practice and how it may still be viable in the new environment.