Don’t Believe What You Read
Amazing.
In one single thread of the Great Falls Tribune forums about the continuance of the doctors’ trial against the Great Falls Clinic, I was able to find much more false than true. Examples:
“This is on the same vein as a non compete agreement and they are not legal in the state of Montana.” False. Covenants not to compete are legal in many varied circumstances in Montana. Further, not all of the contracts at issue in the case were covenants not to compete.
“When my doctor left the clinic, we had to call our insurance company because the clinic sent them notice that we changes doctors!! umm no we didn’t.” False. The Clinic merely informs the insurance carrier that the physician is no longer part of the network.
“The GFC’s response was well, we are just a billing company. JUST A BILLING COMPANY?? Which turns out to be the truth Great Falls Clinic by all purposes is not doctors, the actual company the doctors sign up with is a collection firm.” False. The Clinic is a Montana Limited Liability Partnership; it’s partners are physicians.
“I contacted my insurance company, who did a 3 way call with me on the line, and the person at the clinic told us that they didn’t have to file my insurance if they didn’t want to it was up to me to make sure that it was filed.” True. Your contract is with the provider. If your insurance refuses to pay, you are still liable to pay the bill.
“GFC is a bully in our community, trying to force the best doctors to stay with them so they can have the business if not the Doctors must leave. giving [sic] the citizens of Great Falls the bad end of the stick.” False. Do you have any idea? Have you given the slightest inkling of thought of just what it takes to recruit and equip a physician, and then provide him with patients and incomes until s/he can build a practice? These physicians signed these agreements voluntarily when they became partners. They were not employees, they were owners. They gladly reaped, or would have reaped, the benefit of similar agreements if other doctors left. The doctors are absolutely free to leave. They just are not free to have a practice handed to them, walk across the street, and take the practice (that they developed using assets belonging to the partnership) with them.
No matter the legalities and business strategies, it is somewhat distasteful and unsettling to see “how sausage is made” at the same institution where I’ve had my mom treated for lung cancer, wife biopsied for breast cancer and son evaluated for brain tumors. All worked out OK but the level of trust is huge. I can only trust that the infighting over money doesn’t effect patient care but I have no way of knowing for sure. It would be comforting to know, in my white fluffy clouds and pink elephant world, that all partners remain in the Clinic because they want to and not because they signed a contract. And in case anyone tries to pigeon hole me or elevate my opinion to post subject ridicule;) , Go Clinic, Go Benefis and Go private practitioners!
If it is an integrity problem then you can bet the lack of integrity will “effect patient care” at some point… as GeeGuy so aptly notes:
“They just are not free to have a practice handed to them, walk across the street, and take the practice (that they developed using assets belonging to the partnership) with them.”
It seems being honest in a partnership by honoring one’s contract is the touchstone for white fluffy clouds and pink elephant world.
Geeguy, It would have helped if you had not taken my statement out of context. My insurance Company WAS contacted, As I said in my message on the thread, it was a 3 way call between Myself, Cigna and a representative of GFC. THEY told Cigna and Myself that they were a billing company. Their representative chose to use those remarks not myself. Also, the procedure I went to the clinic for WAS covered and pre-approved as I had also stated. I was sent a statement from the clinic marked Paid by insurance balance total 629.89 Balance due. 0.00 . 3 years later I was sent ANOTHER bill by a credit department stating I owed 629.89 so I called my now old insurance carrier Cigna and they had recorded that it was pre-approved but the collector never filed. On that 3 way call Cigna stated they would be happy to pay the outstanding balance if they could get an account code from the company. What were they told? NO. it was too late and I now owed 629.89. So I scraped the money up and sold some things that were valuable to me to pay this debt..only to receive a check back 7 months later in the amount of 620.89 along with the check was a letter stating that my account had been overpaid and a insurance had covered the amount……But wait there is more, I call Cigna, they HAD paid after the 3 way call. someone. had accepted my payment after it had been made, 4 months ago I receive a letter from that same company…Stating that I owe 629.89. I know darn well I am not the only person who has encountered these issues.
My business is not to think about what it takes to get good doctors in our community, I don’t work for a corp. that would lend me the experience to do so.
My job is to know what doctors to take my family to and if they are beneficial to my family. Is GFC good for family? NO! Not when they can’t get their billing habits right and then say…oh we are JUST a billing company. 629 may not sound like a lot to you, but to me that’s money that could have paid rent and a few bills.
When THE PROVIDERS billing agency sends me a letter stating that my bill is paid. You would think that a bill is paid, If I had received nothing, YES I would have been on the phone with everyone making sure the bill got paid.
And nothing changes my opinion about GFC. Who loses in the end, when a company ties in contracts? Shame on the doctors for doing so as well. But a company who has so much “compassion” for a community darn well should see to it that their “compassion” actually goes to the community. The best doctors I ever took my kids too now reside in billings and Helena. And so that is where MY money goes..
And as for Wolfpack…YES GO BENEFIS and GO DOCTORS.
(Benefis actually gives a care.)
Do you still have all those records?
So, what you are saying is that you have paid the 629. The carrier has paid 629. And you’re still being billed for 629. Right?
I must be the exception; I use both depending on what is needed and have never had any problems with the Clinic or Benefis.
You are saying that the Doctors that work for the Clinic never had a practice before moving to the clinic? These doctors were all new? They NEVER brought their OWN patients with them? It sounds like that is what the clinic it saying.
I have a buiness, and want to move my buisness to a better location, I bring my clients with me, and make more at this new location. Problem this new location tells me I now can’t leave, and if I do, I can’t work in the same town again? OMG, how wrong. If the company I went to work for is so good they should have no problem keeping the clients they already had prior to me signing on with them.
The Clinic needs to wisen up. I will NEVER go there again. Not after the crap they tried to pull with MY doctor.
Oooo…the poor doctors, huh? This is a contract, they sign it. Maybe you should be mad at your doctors for contractually limiting their ability to serve you so that they can reap the benefits when other doctors leave the practice before them…
Although there might be a contract in force here and all parties signed; if this so called contract is found to violate any laws then it could be voided by the courts. Although contracts are in force they can not violate law.
Was re-reading this post and some of the replies. One must know the in’s and out’s of their respective insurance. “I contacted my insurance company, who did a 3 way call with me on the line, and the person at the clinic told us that they didn’t have to file my insurance if they didn’t want to it was up to me to make sure that it was filed.” This statement could be True or False depending on your insurance. With my insurance, because the Clinic is listed as a “Prefered Provider” once I have received the authorization from my insurance to obatin the approved medical care, it is the Clinic’s responsibility to file with the insurance company in accordance with their contract as being identified as a prefered provider. Also if other medical care is required the clinic must also file with the insurance company for the authorization. The clinic also agrees to accept what the insurance company identifies as proper payment for the proceedures and can not bill me for the remainder. Also if the insurance company identifies a cost as a disallowable cost I can not be billed for it. My portion of the bill is always $12.00, $25.00 for surgical proceedures and $25.00 for room and board if a stay in the hospital is required. Benefis also is a preferred provider so they must also play by the same rules with my insurance. If either does not file a claim for the medical care, they can not bill me nor seek a bill collector. They must file with the insurance company.
There are insurance companies out there that although the hospital or clinic may file the claim it is not their responcibility. It is the responcibility of the insured.
Why is it so important to you guys to blame the Clinic? It is not some faceless machine. It is a partnership of doctors. When a new one joins, he or she is about to become an owner and, therefore a beneficiary of the very contract they are now complaining of. Do you think it is reasonable to read the contract one way when it suits you, and a different way when it does’t?
Chello, I am typing this on my iPod, so a response to your detailed post will have to await my nearer proximity to a real keyboard.
Be advised, not all the doctors who are with the clinic are partners.
I don’t understand the hostility towards the clinic either. Doctors are well educated. If one of them signs with the clinic, they know what the deal is right away if they become a partner. Whether that contract is right or wrong is another subject. If I sign a contract with someone, and then I break the rule(s) of the contract… then I fully expect ‘the someone’ has the right to do something legal to me. Most, if not all, of the arguments by folks against the clinic sound emotional and/or personal.
I for one have no hostility towards the Clinic or Benefis. Both have given me outstanding medical care. Sometimes the Clinic can take care of the problem and sometime it is Benefis.
GeeGuy,
Just as it is important for the doctors to read their contract with the Clinic it is also very impotant for people to read what their insurance contains. The only way out of this for the doctors, in my opinion, is if there is a law in Montana that stipulates that such types of contracts are illegal.
I agree with the Clinic, why would you make someone a partner, use your assets to help them get started, only to have them at a later date take such business away? Sounds like standard business practice to me and I would be surprised if the doctors won this legal action.
The Great Falls Clinic (GFC) spends a significant amount of money in recruiting doctors to this area. After finding the right candidate the clinic will hire them as a pre-partner. The pre-partner is paid a salary and benefits, which include malpractice insurance. The salary typically exceeds the amount of revenue the pre-partner doctor generates in the first year or so prior to partnership (i.e. it costs the current GFC physician partners thousands of dollars to bring on a new associate). Most of the doctors recruited by the Clinic are new to Great Falls and therefore do not bring patients to the practice.
In preparation for the new doctor starting practice, GFC hires nurses, assistants, receptionists, etc. GFC will furnish a space as well as purchase new supplies, surgical instruments for multiple facilities, computers, lasers, imaging, and other technologies just for this doctor. It is not unusual for the Clinic to pay fifty to two-hundred thousand dollars upfront in bringing on a new doctor. Some of the new technologies will pay for themselves and some will not. Depending on their specialty, some partners will generate enough revenue to cover themselves and some will not.
The clinic will market the new doctor both internally and externally. The best marketing is word of mouth referral from patients, staff, or other clinic doctors. GFC support for the pre-partner is clinical, administrative, financial, and emotional.
After a period of close observation, most pre-partner doctors are asked to become partners after eight to twelve months. When a doctor becomes a clinic partner he/she becomes an owner. There is no categorization based on seniority.
The day the new doctor becomes a partner, they own approximately a 1% share in a multimillion dollar business. Should that business be sold the next day, for example, the partner would make a large sum of money despite having contributed almost nothing financially to this entity. In addition, a significant portion of the GFC profits are equally distributed amongst partners regardless of the amount of revenue the individual doctor generates. This type of profit sharing is a principal tenet of multispecialty groups. It allows these organizations to adequately retain and reimburse physicians in specialties that do not pay well (typically nonsurgical) in order to provide a greater range of services for patients in the community.
The GFC partnership contract simply attempts to recover some of this Clinic investment should a partner choose to leave the clinic and stay in the area to set up practice. It is a common practice in medicine. It is legal, enforceable, and certainly not unique to the GFC. It was written by some of the best health care attorneys in Montana and the restrictive penalties were specifically designed to be limited and reasonable. Partners of the GFC are free at any time to leave the clinic and practice anywhere they choose. In fact, those involved in the lawsuit against the GFC, all stayed in town, and I believe for the most part have thriving practices.
Most of the doctors involved in the lawsuit, were partners at GFC for many years. They agreed with and benefitted from the contract that they signed. They are excellent doctors and had outstanding practices while they were in the clinic. Their practices were built not only on their own skill however, but also on the backs of the generous support of their partner friends as well as the experienced nursing, clerical, and administrative support team.
The doctors who left the clinic, in my opinion, did so primarily for financial reasons. Nearly all of them were doctors in lucrative specialties who had well-developed practices at GFC. This allowed them to be somewhat immune from new competition if they stayed in Great Falls. They factored in a lower overhead in private practice as they would no longer be subsidizing those doctors in primary care who had graciously supported them through the years with direct patient referrals. They did not leave because of clinical or other professional limitations. They left because they simply wanted to put more money in their pockets. It was a pure business decision on their part to directly compete with the partners who had supported them. The trade off for these doctors was in having to honor their signature on a valid partnership contract that they had endorsed. This is not rocket science. Having an MD behind your name should not allow you to violate legal contracts, but ‘hey, I’m not a lawyer’.
What is the length of this contract. How many years do the doctors have to put in before the contract is up, or they renew?
What happens when a general practisioner decides that would like to spend more time with his family, or has major problems with his staff? (staff calling in prescriptions w/o doctor orders) The doctor complains about this, and nothing gets done.
The clinic, in my opinion has too many patients for its facility, or mabey it has too few doctors. I call in for prescription refills for my grandmother, and it takes two days or more before a call back…..or if she is ill they say take her to the er. Not a very inviting attitude for such a wonderful practice.
I must say I love the specialty clinic, but the internal medicine doctors and family practition doctor need some bed side manners taught. They also need to either NOT take in anymore patients, or refer them to other doctors…..they should NEVER ingore a patient.
Geeguy,
yes, yes and yes. And we are still to this day trying to get the issue solved. In essence GFC has double dipped, un double dipped and is retrying to double dip, sadly I have had to continually send word to the credit companies with the same records that I still hold on to. So that I might be able to get it cleared on that end.
Aphoticbeauty, please send me an email and I might be able to help you out.