Non Contracted Managed Care Issue
- Posting on behalf of another office-general surgery in Washington State.
"I'm getting more and more confused over DSHS/Molina(Managed Care)/CHPW
(Basic Health Plan-Managed Care).
We are only contracted with DSHS on an emergency basis only. We are
NOT contracted with Molina or CHPW. Molina keeps telling us we
cannot balance bill pts as they are the same as DSHS as the card says
Healthy Options so that is suppose to tell me we cannot balance bill
pt. I do not believe this is true. Pts we see with these insurances are
always from the hospital emergency and/or his on call committments.
My question is whether this is true or not. I can't find anything that
supports what the Molina rep told me. We do balance bill these pts but
give them a huge discount - better than MDC. Molina won't pay for
their surgeries - not a dime of it - only the consult so this forces us
to balance bill the pt for the surgery.
My question is can we balance bill pt after Molina and CHPW pay what
little they pay even if we aren't contracted?"
Melinda Brown, CMBS