Monday, March 28, 2005

Negociating Higher Fees

Is it possible to get a higher fee schedule from an insurance company than their standard PPO fees? If so how do I go about it?

Usually not. Why? PPO schedules are published to both doctors and patients. If a patient were to receive say, a crown, from Dr X who had negociated a higher benefit, that additional money would have to come from either A - the patient, who could perceive this plan as a bait and switch or B - the insurance company, who base their premiums on anticipated payment based on the fee schedule. In addition, if area doctors were aware that another was receiving a higher benefit, they would also want an increase.

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