Cards promise discounts, deliver headaches

Consumers are buying cards for discounts on physician services. Doctors could be forced to accept them, ready or not.

By Tyler Chin, AMNews staff. May 19, 2003.

With increasing numbers of uninsured patients, the market has become ripe for the return of the health discount card, which offers -- for a price -- cheaper care for consumers who go to a participating physician. The problem is, physicians often don't know they're participating until a patient presents the card.

What's happening is not illegal, but it is troubling for many physicians. Doctors don't sign contracts directly with discount card firms. Instead, some PPOs have agreements with card companies or their agents that allow them to put network physicians onto the discount list. Then the PPOs include a line in the doctors' contract requiring them to accept those cards.

Patients are told that they are getting a "discount," but what they pay physicians is either the contracted PPO rate or a rate the card companies or their agents have negotiated with the PPO. It is not known how many preferred provider organizations are participating.

Doctors aren't necessarily against the concept of discounts but would prefer that patients work out a payment plan with the practice rather than buying a card. But more important, doctors want PPOs to ask explicitly for their consent to participate in the card programs and tell them what they are accepting.

"It's kind of underhanded not to give us this information upfront and have [the cards] come as a big surprise," said Julie McCuistion, business office manager of 10-doctor Pediatric Associates of Dallas.