You ain't nothin' with a blank contract

Health plans often ask physicians to sign contracts that don't tell how much is paid for each procedure. The AMA House of Delegates is calling for state regulators to require that private insurers reveal their fee schedules.

Editorial. Jan. 3/10, 2005.

The legendary songwriters Jerry Leiber and Mike Stoller penned "Jailhouse Rock," "Hound Dog" and other big hits that propelled Elvis Presley to superstardom in the 1950s. What thanks did they get? Presley's manager, Colonel Tom Parker, demanded Leiber and Stoller sign a contract consisting of nothing but a blank piece of paper and lines for their signatures -- if they wanted to keep writing for Elvis.

Physicians surely can relate to Leiber and Stoller's story. Physicians get contracts from health care plans that, though they aren't actually blank, may as well be. Often, these contracts don't state what a managed care company plans to pay for each procedure.

Leiber and Stoller, operating with an explosion of rock and R&B acts at their disposal, declined Parker's contract.

Physicians, faced with a lack of health plans at their disposal as companies consolidate and gain a greater stranglehold in their communities, often feel they must accept a major health plan's contract. That is, unless the practice plans on treating patients on a cash-only basis.

The problem is compounded with the growth of health-plan deductibles and health savings accounts. If patients want to know how much a procedure costs under their plan, they may ask their physicians -- not that they'll know.