Guest guest Posted February 3, 2012 Report Share Posted February 3, 2012 After looking at ATA's contract, I am amazed there are actually people that take that program. The reimbursement seems ridiculous. If any of you take it, how do you do that and operate? Curious. Thanks! Heidi Billing Manager Lees Summit, MO RE: Humana Going in network is a tough decision as well. In my discussions they only ffer 70% of Medicare and have remained firm on the pricing. It's not a ominate payer in our area so we have avoided enrolling. But, after looking at it, when you break down other agreements in comparison hey are similar. (Optum/United/Pacificare, Cigna & BCBS flat fee/visit, ATA's flat fee per vent, and other fee schedule offerings (Aetna, etc.) From: PTManager [mailto:PTManager ] On Behalf f lydia radosevich ent: Thursday, February 02, 2012 8:40 PM o: ptmanager ubject: Humana Hi Group, ondering how others experience is with Humana. We are not contracted with hem, but my billing manager is telling me of how they have given us uthorization, but then not pay us. Would like to know if others have had roblems with them. Need to decide if we will accept any more patients who ave Humana or how to handle it. hanks ydia Radosevich,PT uidoso,NM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2012 Report Share Posted February 5, 2012 The problem with private insurances is they know to get individual or group plans appealing to consumers they only need to worry about good coverage for doc visits, hospitalizations and medications. They know they can nickel and dime other healthcare options because they are less important to the uninformed consumer until they have to utilize them. Its our job and the APTA's job to market our profession to the public. Otherwise we'll continue to have zero clout with insurances. Bisesi MPT Winter Haven Fl ------------------------------ >Just got out of it. > >A little over 2 years ago Aetna sent a cancellation notice to all PT/OT >providers in North Texas directing them to ATA (Doral). There was no other >choice if you wanted to see their members in network at that time. We had >always been direct with Aetna, we opened in 88. > > > > > >From: PTManager [mailto:PTManager ] On Behalf >Of Heidi Harmon >Sent: Friday, February 03, 2012 10:57 AM >To: PTManager >Subject: ATA > > > > > > >After looking at ATA's contract, I am amazed there are actually people that >take that program. The reimbursement seems ridiculous. If any of you take >it, how do you do that and operate? Curious. Thanks! > >Heidi >Billing Manager >Lees Summit, MO > > RE: Humana > >Going in network is a tough decision as well. In my discussions they only >ffer 70% of Medicare and have remained firm on the pricing. It's not a >ominate payer in our area so we have avoided enrolling. >But, after looking at it, when you break down other agreements in comparison >hey are similar. >(Optum/United/Pacificare, Cigna & BCBS flat fee/visit, ATA's flat fee per >vent, and other fee schedule offerings (Aetna, etc.) > >From: PTManager <mailto:PTManager%40yahoogroups.com> >[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On >Behalf >f lydia radosevich >ent: Thursday, February 02, 2012 8:40 PM >o: ptmanager <mailto:ptmanager%40yahoogroups.com> >ubject: Humana > > >Hi Group, >ondering how others experience is with Humana. We are not contracted with >hem, but my billing manager is telling me of how they have given us >uthorization, but then not pay us. Would like to know if others have had >roblems with them. Need to decide if we will accept any more patients who >ave Humana or how to handle it. >hanks >ydia Radosevich,PT >uidoso,NM > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2012 Report Share Posted February 5, 2012 I would love to see a product come on the market that offered true catastrophic health insurance that was affordable and obtainable. As a small business owner, I do not have access to enough employees for a large group plan. We have been paying for insurance for years but never actually met our deductible in the 12 years we have been in business. The only benefit we receive is group discounts (yep the insurance plans screw the private practices like , etc.. but what's a consumer to do but stick it to people like . sorry dude). It really upsets me that the private practices really have to fight for any payment and then the customer thinks they really have insurance when it's really just strong-arm discounts that only save the insurance company money. Am I missing something ? I know Dave Milano will say go for MSA and I would love to . but could not qualify at my age and a chronic medical issue. I guess I just have to wait till I can get on fixed income and Medicare before I can get ahead. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of keith bisesi Sent: Sunday, February 05, 2012 1:31 PM To: ptmanager Subject: RE: ATA The problem with private insurances is they know to get individual or group plans appealing to consumers they only need to worry about good coverage for doc visits, hospitalizations and medications. They know they can nickel and dime other healthcare options because they are less important to the uninformed consumer until they have to utilize them. Its our job and the APTA's job to market our profession to the public. Otherwise we'll continue to have zero clout with insurances. Bisesi MPT Winter Haven Fl ------------------------------ >Just got out of it. > >A little over 2 years ago Aetna sent a cancellation notice to all PT/OT >providers in North Texas directing them to ATA (Doral). There was no other >choice if you wanted to see their members in network at that time. We had >always been direct with Aetna, we opened in 88. > > > > > >From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf >Of Heidi Harmon >Sent: Friday, February 03, 2012 10:57 AM >To: PTManager <mailto:PTManager%40yahoogroups.com> >Subject: ATA > > > > > > >After looking at ATA's contract, I am amazed there are actually people that >take that program. The reimbursement seems ridiculous. If any of you take >it, how do you do that and operate? Curious. Thanks! > >Heidi >Billing Manager >Lees Summit, MO > > RE: Humana > >Going in network is a tough decision as well. In my discussions they only >ffer 70% of Medicare and have remained firm on the pricing. It's not a >ominate payer in our area so we have avoided enrolling. >But, after looking at it, when you break down other agreements in comparison >hey are similar. >(Optum/United/Pacificare, Cigna & BCBS flat fee/visit, ATA's flat fee per >vent, and other fee schedule offerings (Aetna, etc.) > >From: PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> >[mailto:PTManager <mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com> ] On >Behalf >f lydia radosevich >ent: Thursday, February 02, 2012 8:40 PM >o: ptmanager <mailto:ptmanager%40yahoogroups.com> <mailto:ptmanager%40yahoogroups.com> >ubject: Humana > > >Hi Group, >ondering how others experience is with Humana. We are not contracted with >hem, but my billing manager is telling me of how they have given us >uthorization, but then not pay us. Would like to know if others have had >roblems with them. Need to decide if we will accept any more patients who >ave Humana or how to handle it. >hanks >ydia Radosevich,PT >uidoso,NM > Quote Link to comment Share on other sites More sharing options...
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