August 08, 2014
As mentioned back in the April letter, several insurance companies began requiring their physicians to have their patients execute a company disclosure form prior to referring the patient to a provider/facility that is not a participating provider. Aetna, United HealthCare, and Cigna adopted such a policy. When these insurance companies began this mandate, they reserved the right to audit physician records to ensure compliance.
Providers should ensure that all patients have executed their respective insurance company disclosure form prior to any referral to a non-participating provider and to maintain such disclosure form in the patient file.
As always, while we understand that the practice of medicine is your primary focus, we also strongly encourage you to consider the importance of compliance and fostering a compliant work environment for your employees to permit you to continue doing what you do best.