Beware of “Accidental Contracts” With Insurance Providers

Health care providers should be aware that informational forms sent by insurers may lock them into unfavorable contracts. In many cases, these forms are faxed to front-desk staff or mailed to physicians at home. The form may include language that purports to be a contract binding the practice to lower reimbursement rates for certain groups of patients or services.

 While these practices may be challenged in court under a number of different theories, the easiest way to avoid these issues is preventive. Your practice should establish policies for handling information update forms and other correspondence from insurers. These forms should be signed only after careful review, and not by a physician without appropriate authority to do so or a front-desk staff person.

© 2014 Parsonage Vandenack Williams LLC

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