Fed up with Health Plans? How to Resign
by Barbara Griswold, LMFT (Updated September 22, 2017)
- Think twice. It may be hard to rejoin if you change your mind, so don’t make this decision out of anger.
- Consider asking for a raise, if reimbursement rates are the main issue.
- Plan ahead. Your contract may require 2- 4 months’ notice before leaving. Check your contract, or contact the plan.
- Contact Provider Relations to find out who to notify. You can’t resign via Post-It note on a claim, or fire off an email to any office at the plan.
- Usually you must resign in writing. Many plans accept a fax.
- Name a proposed resignation date that gives the required notice.
- Ask the plan to hold new referrals until the resignation is official.
- Get written confirmation from the plan. Follow up until you’re sure you are off their provider list. Otherwise, future claims from clients with out of network benefits may be incorrectly processed.
- Give clients several months’ notice. Give them written notice with your resignation date, how this will affect them, and what their options are for continuing treatment, including referral to a plan provider. Keep a copy in the client’s chart, and document all discussions. Don’t wait — the plan may send clients a letter notifying them of your resignation, and you don’t want them to find out that way.
- Have clients check it they have out-of-network benefits that might cover therapy after you leave the network.
- Decide if you will offer affected clients a reduced fee, or perhaps for a period of time.
- Consider how it may affect each client emotionally. This may bring to the surface abandonment issues, shame about finances, whether the client values therapy enough to pay out of pocket, or serve as an uncomfortable reminder to both of you that this is a business relationship.
- Have continuing clients sign a “Self-Pay Agreement.” This agreement states that as of a certain date their sessions with you will no longer be covered by their plan, states the fee they must pay, and that you will no longer be billing insurance for them.
- Remember: Resigning does not mean you are free of chart reviews or treatment reviews by health plans. Your clients with out-of-network benefits will be submitting invoices to their insurance plans, so your notes must always document medical necessity for treatment. For more on great documentation, click here
Want to schedule some time to discuss whether resigning insurance plans is a good idea for your practice, discuss clinical challenges, and plan a wise exit strategy? Contact me for a consultation.