Providence Antitrust Action
March 19, 2007
Dear Referring Clinician and Staff:
Giving physicians access to the very best technology and service at an extremely competitive price has always been the cornerstone of Body Imaging Radiology’s (BIR) and Pacific Breast Center’s (PBC) business philosophy. Recently the anti-competitive decision of Providence to terminate our center without cause from its PPO panels has resulted in confusion and significant frustration among our referring healthcare providers.
After painstaking research we have determined that in spite of Providence’s best efforts we can effectively and legally match the in-network insurance benefits of anyone the law allows. This decision applies specifically to patients covered by Providence insurance products and the over 125 insurance plans controlled by Providence through its rented provider panels who would otherwise be required to pay higher rates should they choose to go out-of-network. These patients may now come to BIR and PBC and not pay one penny more than they would have if they had gone in-network.
We hope this will help to alleviate the tremendous burden that the Providence decision has placed on your staff and that they may now be free to focus on getting your patients speedy service as opposed to determining insurance eligibility. Unfortunately, the law does not allow us to match in-network benefits for Medicare and Medicaid patients covered through Providence and its PPO panels at this time. That, however, is the only exception to our policy.
Since our termination by Providence, we have been honored and gratified by the support of our referring community. Providence’s decision is intended to make it difficult for our referring offices to take the time to sort through which patients can go to which facilities. There is no doubt that this nuisance factor was always a part of Providence’s plan to redirect referral patterns to their own facilities. While potentially costly for BIR and PBC, we hope this new policy will be a positive step toward preserving physician access and patient choice in Oregon.
Our customer service representatives will be calling on your staff to provide details and answer any questions. Should you have immediate inquiries, please call our billing department at 503-968-2885.
Sincerely,
Paul Meunier, M.D.
Medical Director
Body Imaging Radiology
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