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ACN Policy Change
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ACN Policy Change - January 11, 2007 12:35:00 PM
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Colonial1672
Posts: 12
Joined: September 13, 2005
Status: offline
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I just received an email from the APTA.
It seems ACN/United Healthcare has made some recent changes to how they intend to pay for physical therapy services (depite the APTA's concerns and advice against doing so).
ACN now proposes to make a single daily payment regardless of the services delivered.
What are your reactions? What should be done?
The APTA recommends we go to the "resources for challenging times" on the APTA's website for ideas on how to practice in this "climate".
And they will continue to monitor these environments to advocate for a fair and reasonable solution.
Even though the APTA has met with ACN four times since 2005.......
There was no mention on how much this dollar amount is going to be.....but it can't be good.
Please respond.
Tom Hoffman
Member NJSIPT.com
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Re: ACN Policy Change - January 16, 2007 7:59:00 AM
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tnt
Posts: 22
Joined: April 18, 2005
From: Wisconsin
Status: offline
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Maybe somebody can correct me if I'm wrong, but I seem to remember practicing in Illinois several years ago, and having a "single day" payment from United Health Care....something around $60/visit no matter what services were performed.
Since this time, the debate has raged as to "what should we do as P.T.'s"? The answer is simple: we SHOULD "just say no" to the contracts. However, the reality is not so simple: UHC is a strong player with a lot of members, and many of us need access to this large pool of patients.
In reality, the only people who will have any influence over changes made by UHC are their clients and the large corporations who are contracting with them for coverage of their employees. If these people have nowhere to receive services, they will complain to their insurance. Otherwise, as far as people who carry UHC insurance are concerned, they have great coverage. For the most part, all they know is that their out of pocket expense is minimal; they have no idea that their coverage pays minimally for our services.
Bottom Line: until payees band together and UHC has nowhere for their patients to receive services, they will continue to squeeze.
For the record, my private practice has "just said no" to UHC. I feel that I could be seeing increased numbers if I were an in network provider, however the amount of profit would likely change minimally. By the way, some UHC out of network benefits aren't too shabby......
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