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.
Blessings,
Dani Williamson
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