Unfair insurance practices: Help the FMA fight for you!

FMA Staff Report

This year, the FMA will pursue legislation to prevent unfair insurer practices that can lead to a loss of revenue for physicians: contractually-mandated credit card payments in lieu of electronic fund transfers and retroactive denials, wherein an insurer authorizes a service or procedure but later seeks to deny payment or recoup funds based on a change in the patient’s coverage status, such as a loss of employment-based coverage.

Medical practices should not be forced to lose money because of fees associated with mandatory credit card payments, nor should insurers be allowed to recoup funds or deny payments for services that have been duly authorized.

We need your help to advocate for legislative reforms. If you have experienced either of these issues and would be willing to testify before lawmakers in Tallahassee or speak to your state representative or senator about these matters, please contact us by emailing FMA Director of Health Care Policy and Innovation Jarrod Fowler at jfowler@flmedical.org.

Specifically, let us know if know if you have any experience with one or both of the following:

• Being contractually forced to accept credit card payments from insurance companies in lieu of electronic fund transfers. Credit card payments can result in delayed payments or cost physician practices revenue in the form of excessive fees or other related expenses. Unfair insurer clauses that mandate the acceptance of credit card-based payments can reduce the amount of revenue received by private medical practices and/or delay payment.
• Having payments for authorized services retroactively denied because a patient lost their existing healthcare coverage or discontinued paying their premiums for reasons such as a loss of employment. When a patient loses coverage, payments may be recouped or denied even if the physician sought and received prior authorization in advance of delivering them. While this unfair practice can be especially costly for procedural specialists, it can affect practices of all kinds significantly.