Telling patients you dropped their health plan

March 7, 2008

I declined to renew my provider contract with an insurer whose reimbursements are too low. Who should notify the affected patients--the health plan or me? If it's up to me, what should I say?

I declined to renew my provider contract with an insurer whose reimbursements are too low. Who should notify the affected patients-the health plan or me? If it's up to me, what should I say?

You should be the one to tell them. Say that you'll no longer be a provider for their insurer as of a certain date. It's not necessary to explain why you left the plan. Thank them for the privilege of having been their physician and assure them that you'll be happy to continue seeing them out-of-network. List the other plans you belong to, just in case that's an option for someone.

To assist those patients who'll need to find a new physician, suggest that they contact their plan for names of other providers in the area who are accepting patients. Also give the number of the local medical society for help in locating a new doctor. Let them know you'll promptly forward copies of their records to the doctor of their choice, upon their written request.