Recently we’ve exposed how insurance companies have been increasing premium rates while decreasing their coverage and their deception to get subscribers to pay high PPO premiums yet they pay out low Medicare rates to providers. We’ve just discovered how insurance companies collaborated with Multiplan, an unethical company hired by insurance companies to bully healthcare providers into a “take it or leave it” offer.
In February of 2020, Multiplan merged with Churchill Capital and went public in October 2020. Multiplan had lied and inflated their worth to sell shares to investors at a high rate but in reality their worth was declining. Insurance companies like Anthem Blue Cross used Multiplan to negotiate their provider and facility fees. They used Multiplan as a tactic, much like good cop bad cop. The insurance companies start off with a ridiculously low settlement offer knowing that the provider and facility will reject it. Then Multiplan acts like the good guy and comes in with a little higher offer, but not even close to the usual & customary rate. This Multiplan offer is sent to providers via a letter stating that they were hired by the insurance company to handle the settlement and that this is the only and final offer the provider will receive. The letter sounds more like an ultimatum from a gangster than a negotiation. This leaves providers and facilities with really no choice; either take the offer or get nothing.
“Take it or leave it”
What has recently been revealed is that Multiplan was the middleman playing both sides and taking the difference for themselves. They inflated allowable rates to insurance companies but gave medical providers a different allowable rate. These rates seemed almost made-up and had no evidence as to how they were determined. Multiplan had been giving inaccurate pricing data to both doctors and insurance companies and pocketed the profit. So, the insurance companies got screwed by their own partner whom they believed were saving them money.
This comes to show that when you are operating unfairly and you try to cheat others from their business, others will cheat you. That’s karma for you.
If you are a provider that feels you’ve been pressured by Multiplan or the insurance companies to accept an unreasonable rate for your services, contact the Department of Insurance at 800-937-4357 or Department of Managed Healthcare at 916-324-8176.
