Questions for Dr. Stern
About Your Urgent Care Center
70. I want to know if you have some good suggestions and input for negotiating a contract with insurance company. UHC wants to see pts. come to our clinics and would like to offer a set fee. Do you think that is better or whatever they link to Medicare rates? What would you feel is a good number per pt. charges? I mean a flat fee per pt. Or should it be per fee schedule? I know you are good at all this and I am sure will recommend something good.
Good to hear from you. At Physicians Immediate Care, we have been very successful in avoiding flat-rate (or visit-rate) contracts. In states where they have become dominant, they have become a big problem as payors separate out urgent care centers (which are few in numbers) from all other physician contracts, and then they ratchet the fees down over time. Without comparison rates (with other physicians), UCCs lose their negotiating abilities. In Arizona, visit-rates as low as $65 are now being offered. In addition, because our physicians code so well by using Practice Velocity, we would not want to lose this advantage by signing flat-rate contracts. I have spoken and written on this subject, and I include a column on this subject that will appear in the next issue of Immediate Care Business. If you do still think that you must sign this contract, feel free to call me to discuss. There are multiple different ways to improve visit-rate contracts or to convince the payor that it is not in their best interest.
