I recently received a call from a CA who was fighting with an insurance carrier over denial of a product that had been precertified. The product was included in the managed care policy the doctor signed with the company and the company had been paying for the procedure up to that point. I offered several options for one of which was Promissory Estoppel. This action isn’t common and it can be a long shot. WHat is it?
Many doctors and their staff members have never heard of Promissory Estoppel. Have you?
How about these terms:
Any willing provider, upcoding, down coding, unbundling, maximizing, Locum Tenens
Give it a shot at defining these and next post I’ll provide the answers.