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Membership fee with insurance contracts

  • 1.  Membership fee with insurance contracts

    Posted 07-19-2019 11:12
    Anyone out there contract with insurance (we take Medicare/ Medicaid and private) AND charge an annual membership fee?

    I’d love insights, tips, tricks.

    I understand but am not sure that it is legal as long as everyone signs a non- covered waiver.

    Melissa Weakland, MD
    Ballard Neighborhood Doctors
    7701 15th Ave NW
    Seattle, WA 98117
    Phone: (206)-297-7678
    Fax: (206)-297-5930


  • 2.  RE: Membership fee with insurance contracts

    Posted 07-20-2019 20:33
    You probably need to talk with a lawyer but I don't believe it is legal, because usually the agreement itself would prohibit a "non-covered waiver" as well as any surcharges.   the idea behind the contract itself is that it sets the terms of the doctor providing the services and the payment they thus agree to have suffice for those services, as assurance to the beneficiary.

    deborah  





  • 3.  RE: Membership fee with insurance contracts

    Posted 07-21-2019 04:20
    You should talk to a lawyer. Usually the membership fee covers non covered services such as increased access like getting the doctors cell number, same day appointments etc. we have contracts that explicitly forbid membership fees.

    Larry Lindeman
    Roscoe Village Family Medicine
    iMP since 2004