October 8, 2014
Dear IFM family,
The past 2 months have been a whirlwind of blessings and new challenges for me and my family. Since leaving my last job on August 11 I began an exhaustive 600 page credentialing process with Blue Cross that was to take only 2 months. Tammy has worked like a champion in that process putting countless hours and late nights (as we all have) to provide me the “privilege” of taking BCBS. Since I was not credentialed at my last job, this was a necessity. Three weeks from the time BCBS stated everything was progressing smoothly with credentialing and my supervising MD, I set reasonable fees for non-BCBS patients and opened my doors with their assurance of the process. And the added assurance that any patient I saw with BCBS, I would be able to submit claims to BCBS for payment after credentialing was completed.
Almost 1 month into practice (7 weeks after beginning the credentialing process) while Tammy was continuing follow-up with their progress, they informed her that (even though this is MY practice) the MD who supervises and collaborates in difficult cases must also be in network with BCBS. Despite continual phone calls and status updates, this information was not delivered to us until 2 days before a deadline (Monday night) leaving us inadequate time to find a replacement MD. To top it off, this change went into effect after we began credentialing so there was no way of knowing ahead of time.
Despite thinking through every possible scenario and willing MD’s to supervise me, we are unable to secure an MD and get the paperwork processed through the BCBS system in time. It is devastating to me and my staff to have put so much effort, time, and financial resources into this hoop jumping endeavor all to be treated this unethically and put in a very uncomfortable position both financially and emotionally. My decision to start my own practice would not have changed one bit, but I certainly would have put my efforts into more productive patient related matters (not the hoop jumping we have all done the past few months).
So what does this mean for my beloved patients? If you do not have BCBS this has no bearing whatsoever. If you do have BCBS do not worry. You will not receive a bill from us for our services rendered for past appointments. If you have an appointment tomorrow (Friday October 9, 2014), I will still honor it for whatever your copay is. It is unethical to tell you it will be covered and come back on you if it is not. However, from here out I have to proceed without accepting BCBS and utilizing the fee schedule as I do for my non-BCBS patients already. I am heartbroken to deliver this news to those with BCBS who put their faith in me from the beginning. Your lab coverage will not change and you may file your own insurance if you wish as this is for MY services only. Tammy will help you with that process.
God has blessed me beyond words with an amazing staff, incredible patients, and a peace of mind that has stayed with me through this entire transition. It is time to focus on patients and not jumping through unrealistic and unethical insurance hoops. I completely understand if finances prohibit you from being able to stick with our original treatment plan/frequency. We will do whatever we can to find a way to work with you as we do our current non-BCBS patients. If that means only seeing you 2x a year or less, we will work hard to find a middle ground for all of us.
For those of you seeing Dr. Myers, he will continue to take BCBS since he was credentialed before the transition. Please share this information with anyone you know who has an appointment and BCBS. It makes me sick to think this will causes a disruption in the care of someone who needs it, but please know that we have done everything possible based on what BCBS told our certified biller with 13+ years of experience. Please contact us if you have any questions. As much chaos as it has been, I am excited and energized to move forward and continue walking with you on your healthcare journey. Thank you for your patience and understanding with this sensitive matter.
Fees are as listed:
New Patient: 275.00 for 90 minutes
Follow Up: 150.00 for 30 minutes
Phone Consults: 150.00 30 minutes
PLEASE CALL OR EMAIL TAMMY AT (615) 944-3529 OR INTEGRATIVEFAMILYMEDICINE@YAHOO.COM FOR ALL BILLING AND RESCHEDULING QUESTIONS. WE WILL DEDICATING THIS LINE TO BCBS PATIENT QUESTIONS. PLEASE DO NOT ASK QUESTIONS ON THE FACEBOOK PAGE, WE DO NOT HAVE THE TIME OR STAFF TO ADDRESS THOSE QUESTIONS, THANKS IN ADVANCE FOR YOUR UNDERSTANDING.