Insurers: Switching to concierge practice? Check with third-party payers

May 16, 2008

UnitedHealthcare is dropping four Houston-area physicians from its network for practicing concierge medicine while continuing to bill the insurer for their services.

UnitedHealthcare is dropping four Houston-area physicians from its network for practicing concierge medicine while continuing to bill the insurer for their services. Though it hasn't yet booted any doctors, Cigna, too, is frowning on the practice, in which patients are charged an annual retainer for greater access to their doctor and more-comprehensive care. According to The Houston Chronicle, physicians who belong to an HMO or PPO in the Lone Star state and receive discounted fees for their services can't charge additional fees beyond whatever copays the patient is responsible for. Nevertheless, several other major insurers in the state, including Aetna, Humana, and Blue Cross Blue Shield of Texas, told the Chronicle they don't have a problem with the practice, as long as patients are clearly informed that the plan won't reimburse them for any portion of the concierge fees.