Small Doctor's office wants to recommend insurance policy to patients


Denver, CO
Best answers
So, like the title says, the issue I am facing is that the doctor who own this office wants to get Patients to switch insurance. My assumption is that we are legally not allowed to do something like that. Ethically it seems clearly wrong. Apparently the Doctor is trying to avoid having to switch to EHR, so he wants to limit the amount of patients who have a certain plan because of the guidelines that the Payor sets forth (If you have 100 or more patients with this particular policy you have to switch to EHR).

Instead of switching to EHR, or not being a participating provider, he wants the patients to get a different policy, because according to the Dr A.) the policy is better for the patients. B.) it is better for us too. He believes that Offices show preferential treatment to different insurance companies and plans all the time. And he just doesn't see the problem with recommend a few specific plans. He says that he wouldn't force anybody to switch, nor would he tell them that they cant be seen if they don't. He would just tell them the pro and cons of the different policies.

Anyways, like I said, to me it doesn't sound right. I have advised strongly against doing that. We are a small office. So there isn't any compliance department, or other's who I can consult with. What I need is help finding concrete laws and regulations, that I can print out, and show the Doctor that there isn't a gray area with this. That it is straightforward. And we cannot do that. WIth open enrollment happening, I want to get out in front of this before it happens, and we start breaking some rule.

If anyone has any advice I would really appreciate it. Thanks