Doctors Q & A

Fee Negotiation Agreement

Q. I received a document called "Fee Negotiation Agreement" from MultiPlan. MultiPlan states that it is working for a payer and is asking me to accept a reduced fee for services rendered. What are my options?

A. MultiPlan, Meridian Resource Company, LLC, Global Claim Services and the like are referred to as "cost containment" or "fee negotiation" companies. The payers pay these companies a fee if a provider agrees to accept a reduced payment for services rendered. Therefore, these companies are often quite assertive and have an incentive to minimize your payment.

Fee negotiation companies typically start the negotiations by faxing a fee negotiation agreement to the provider's office. This agreement references a particular claim, sets forth an "adjusted price" and contains a signature line so that a provider may execute the agreement and return it by facsimile.

Many providers simply sign and return the agreement. These providers will typically receive payment within ten days. It is also important to note that providers who accept the reduced payment must refrain from balance billing the patient and refund any related negative balances.

You need not follow the lead of those providers who simply accept the fee negotiation agreement. Instead, it may make sense to call Multiplan. You can explain that the proper usual, customary and reasonable reimbursement is higher than the proposed payment and demand a higher adjusted price; if you do so, you may well be able to increase the adjusted price.

You are also free to ignore the fee negotiation agreement. If you ignore the agreement, the fee negotiation company will likely close the case after one or two weeks. The matter will then be returned to the payer and you will be free to negotiate directly with the payer, without a middleman in the picture.

In summary, don't be afraid to challenge the amount set forth in the fee negotiation agreement. This investment of a small amount of time may very well yield dividends.

Stephen A. Snyder, Esq.
Vice President/General Counsel

Disclaimer: The information contained within the MTBC^® Legal Corner is provided for general educational and informational purposes only and should not be construed as legal advice. The author of the Legal Corner does not represent the Web site user or the individual submitting a particular question. Please seek the advice of legal counsel to address any specific questions you may have regarding your particular facts or circumstances