Q:

Hello Dr. M

I was reading a topic on your webpage for 3/14/00 about HMOs.  I 
understand the reduced fee for a period of time.  Does this mean that 
I would have to charge all my patients the same fee?  If I eventually 
entered an HMO i would no longer be able to charge this reduce fee 
....Correct?  


A:

Thanks for the e-mail. An HMO contract is just that .. a business  
agreement between you and another business .. in this case an 
insurance company and their insured members. Therefore you must 
abide by the contractural agreement as outlined when you were 
invited in with this insurance company for their insured only .. 
including fee and adjustment limits. Once a patient goes beyond the 
allowed number of visits .. you should place them on a maintenance 
type program. I use PCD which helps me lower the fee without the 
dual fee problem. Remember that an HMO agreement with one 
company has no bearing on anything else you do in your office 
outside their insured. Also .. you are bound by this contract as long 
as you continue to be within network.