UPDATE:: Re: Negotiated out-of-network payment services

[Guest guest]

The first time I was dealing with these re-pricers I negotiated a compromise.

Thanks to those in this group, however, I was prompted to look into the FL WC

Manual to find the maximum reimbursement allowed (MRA), which gave me a baseline

to compare to what the re-pricers were offering. Sadly, it wasn't close. So I

got " taken " the first time around.

When they came knocking again for different claims, I returned with a

counter-offer, using the MRA information and decided to stick firm to my

numbers. Well, the same day I sent off my counter-offer I received a check from

the WC insurer for the MRA amount. Apparently the right hand is not talking to

the left hand. Not surprising, but disappointing.

The third time they came knocking I didn't even return with a counter-offer or

return their phone calls, and I received in the mail a few days later a check

from the insurer with the MRA amount.

MORAL OF THE STORY: If contacted by a re-pricer you may be in better shape to

wait and see what the insurer does, despite the re-pricers warnings that their

offer is only good till the end of the day. And also, find out the MRA for your

state.

B Schroedter, PT

Miami, FL

>

> I was recently contacted by National Health Quest offering a settlement on a

WC claim that I find unacceptably low in terms of reimbursement. What happens if

I reject the settlement offer? How much negotiating room does one have with

these types of organizations?

>

> B Schroedter, PT

> Miami, FL

>