We won a great victory – Does anyone know about it?!?

We won a great victory – Does anyone know about it?!?

Transaction #: 123456789

Card Value: $1,500.00

Date: April 1, 2021

When I see this…

  • Why should the clinician have to pay to be paid?
  • Why do doctors have to spend time manually entering all these – there’s not even a QR code or a way to swipe them! Time is money too!
  • How much do you want to bet that the insurance company and Mastercard/Visa are splitting that merchant fee as a “kickback?”
  • They are making me log onto 10,000 different websites to get my remittance information for posting, rather than sending it to me in the mail or via my clearinghouse/software! That is SUCH a waste of my time.
  • They’re saving themselves time and money, at the doctor’s expense!
  • Payers know the doctors don’t have time to figure out these complex enrollments, so they count on people giving up and charging the virtual cards – and they are right.

NO … I’m not opinionated or anything…

Since 2014 when I received the first “Virtual Credit Card” (yes….it really WAS that long ago), the number of payments received in this format has proliferated like, well …..Tribbles.

It used to just be an annoyance, but all you had to do was call and they’d (grudgingly) send you a check.

Now, here’s what happens:

  • Plans will refuse to allow enrollment in automated remits (ERA) unless the provider agrees to accept VCC or direct deposit, often from third-party intermediaries.
  • Often the direct deposit option requires a fee also, which currently can be as high as 2.5%.
  • Some plans refuse to pay by check at all. It’s either direct deposit or virtual card. Even if you’re out of network, out of area, or you only do business with them once every 5 years. Doesn’t matter.
  • If they do agree to pay by check…it can take the check months to arrive, after several phone calls to follow up.
  • The direct deposit registration process is often handled by third-party intermediaries and is incredibly complex and takes months. Which, frankly, I don’t understand. I go to my power company’s website and pay my bill in under 5 minutes simply by entering my routing & account #’s. So why does direct deposit registration with payers take months?

Now that I’ve raised your blood pressure to stroke levels….I have amazing news! We have won a victory over this abuse.

No way, really????

I know, right? Here’s how we fight these virtual cards and unreasonable-fee intermediaries:

On March 22, 2022, CMS quietly issued the following two guidance letters. In dry HIPAA-ese, they upheld providers’ rights.

For Health Plans: https://www.cms.gov/files/document/guidance-letter-vcc-eft-era.pdf

For Health plan vendors/business associates: https://www.cms.gov/files/document/guidance-letter-business-associate.pdf

Help! Is there an English version? I clicked the links, but what does all this gobbledygook mean? What do I need to do?

(Click here for the explanation and permanent solution to this pernicious skimming away of your hard-earned reimbursements.)