WHAT A DOCTOR
GRAPPLES WITH

Many people think all doctors are wealthy. That's not true. Wealthy doctors are usually trained for a specialty such as cosmetic surgery or any specialty practice that doesn't accept insurance. I recently received a letter from a local doctor that is reminiscent of what many insurance-accepting doctors deal with. Read it carefully and think about it.
XXXXXX

My staff and I have spoken with many of you about the changes in our office this last week.
I've received many emails, texts, hand written messages and letters. I have personally read every one of them.
Some of you have been very understanding, and some of you have been down-right nasty. I get it. I understand.

Most other front office medical staff personnel around the valley, and the country for that matter, have no idea that 50% of health care entities are grappling with prescription and payment clearinghouse reimbursement because no one in the news is talking about it. And, those stories that are present have been on the Friday back pages of newspapers and websites.

Many of you didn't read previous emails and are still confused as to why our office is making changes.
First, I have grown to love and deeply care for each of you over the years. This decision to switch and no longer accept any insurance was not an easy one. I may lose many of you as patients.
Second, to be completely transparent, our office received NO payments, nor communication as to why, from ANY insurance for 4 weeks, in the case of Medicare, it's been 6 weeks, despite our calling each of them and asking why. You can read about it here [1].

I, and many other providers I've spoken to over the last month, have been told by all of the insurance companies that "everything is fine" and "we have paid you" when they had not.
Apparently, their computer systems were shut down and their customer service people, being left in the dark, could not actually see what we had billed and submitted and what they paid from January through March. Quite convenient for them, I must say.

According to the American Hospital Association, "the full financial impact of the hack is still unknown."
"Billions of dollars stopped flowing to health care providers because of the data breach."
Medicare, for whatever reason, routinely stops making payments through the month of January (this has been their standard for the last 10 years without any explanation) and then mid-February all the insurance stopped paying due to this "cyber data breach" occurring at Optum's Change Healthcare. That essentially is six weeks without regular insurance reimbursement.

It is physically impossible to operate a business, pay rent, cover payroll and taxes for 14 employees without any reimbursement from insurance for more than two weeks, let alone 4-6 weeks. Small medical offices don't have that kind of cash flow cushion.  (Click here to read the entire article)