11/30/2013    

QUERIES (OBAMACARE)

Query: Obamacare and Podiatrist Fees

 

How will Obamacare affect fees in locations where podiatrists' fees have been targeted by insurance companies with lower fees for the same services provided by other specialists? Will Obamacare put an end to this unethical practice? Will it put an end to a network within a network? The definition of network within a network: An insurance company "carves out a service" (podiatry), has a third-party administrator manage the podiatric services, receives bulk payment from the insurance company, and reimburses the provider. This usually results in lower fees because there are two layers of administrative costs: one for the insurance company and one for the third-party payer.

 

Ira Baum, DPM, Miami, FL

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