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Payor contract in name of practice or practitioner?

March 24, 2016
Question:

Jennifer, 

Should I be signing my payor contracts in my name or my practice's name?  Does it matter?

Thanks, Dr. P

Answer: 

You Betcha!  It matters a whole bunch. The party to the agreement is the party to be bound.  "Ok, but what does that mean?  Can't I get my contractual rates either way?" Sure, either way you may see your contractual rates, but what about your employees?  What about other locations you work in?  I see practitioners make the mistake (often) where they sign a payor contract individually, but believe because they signed the contract while they were sitting in Queens, NY, that contract doesn't apply to their side job in Westchester, NY.  Well, that is simply not necessarily the case. Depending on the verbiage in the payor contract, let's say the contract is with Empire, you may very well have contractually bonded yourself to accept Empire in-network rates wherever you practice. We see this come up often, and with practitioner's abusing in-network status by signing individually and then hiring employees and thereafter foregoing additional credentialing by billing under themselves exclusively, despite not providing the services themselves. A BIG NO NO, and MAJOR red-flag for a payor.  

If you aren't sure how to sign, or if the payor contract is confusing, make sure to have it reviewed and to ask questions before you execute.  AND, DO NOT FORGET TO KEEP A COPY OF WHAT YOU SIGN!!!
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Have a question or comment for Jennifer?
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