Re: Linkia and Managed Care
M. Britt Spears CPO
Description
Collection
Title:
Re: Linkia and Managed Care
Creator:
M. Britt Spears CPO
Date:
7/25/2006
Text:
Jim/List,
I really think that the solution to these problems with closed door insurance companies is the Any Willing Provider Law. Since it's taken effect in Arkansas, insurance companies have been forced to deal with us little guys. They may not send the check directly to you, the patient instead, but you will get paid. I know that it's taken effect in Kentucky where it originated, I'm not sure from our KY people how it's worked there, I'd like to hear from some of them.
We all know that Hanger has created Linkia, I believe it was 3 years ago. If they act as an insurance company and not as a burial policy type of fund, they would be forced to abide by the Any Willing Provider Law.
I personally feel that we need to get AOPA involved in creating a national Any Willing Provider Law policy that can be handed down to each state orginization. The states can then follow thru.
M. Britt Spears CPO
www.Prosthetics-Orthotics.net
Jim DeWees < <Email Address Redacted> > wrote:
I posted an email about Linkia a few weeks ago, I got a huge reaction from
the list, I received many emails from people, all of them very concerned and
frustrated with this situation.
I also got a phone call from the president of Linkia, spent a good hour on
the phone with her about my concerns. We really got nowhere with the
conversation, she tried to pacify me and lead me to believe that Linkia was
only looking out for the best interest of this field, and also looking out
for me as well. I had to laugh at that comment.
As I stated in the last posting, I called Linkia and asked for information
on finding a prosthetist in my zip code or somewhere close. The closest
provider they could offer was about 50 or 60 miles north of me, which is a
Hanger office. I asked if there were any non-Hanger facilities in the area,
and I was told that Hanger was the only facility that was qualified or
trained to do prosthetics in the area.
I also called the number to ask about how I can get in the network and be a
provider (not that I really would accept the low payment and the DEEP
discount that they are offering or allowing under the Cigna plan) and I was
told that I was not able to be in network, they have enough providers
already and were not accepting any new ones.
I called someone higher up the chain, and he told me that they could take my
name and information and when they decided to expand the network then they
might consider letting me be a provider. But as of now (and since their
beginning about 3 years ago now) they are not allowing anyone else into the
network.
I find it very, VERY, interesting that Hanger has supposedly helped fund the
ACA in the fight for parity legislation, which I understand would force
insurance companies to pay equal to or greater than the Medicare allowables,
and not have annual caps or lifetime caps. But, then Hanger, working under
the name of Linkia, has a fee schedule that is deeply cut way below the
Medicare allowables. In fact, Hanger is notorious for going way under
everyone else whenever there is a competitive fee schedule that is being
negotiated. I know this happens, I unfortunately had the experience of
working for Hanger for a long time...8 months...until I had to quit and walk
out due to major ethics issues with the management. That was in Las Vegas,
NV in 2000. I would not do the things that I was being told to do, all for
one big reason...to increase the profit margin and make more money. I know
what the discounts were for many of the insurance contracts there, I got to
see that. It was totally disgusting.
So, why is Hanger spending the time and money to help support this parity
legislation, and then on the other hand, turn around and not only offer huge
discounts to insurance companies just to get a contract? And, on the bigger
issue, now they own an administration group that is also based on HUGE
discounts.
The tougher issue here is: what does this kind of situation do to the
amputees out there? What if the amputee absolutely hates the Hanger office
in their area? What if they do not want to go there for various reasons?
Well, if they have Cigna, that's just tough crap.
Hanger, in many locations...ok, most locations, has not been able to lure
the patients into their offices because of higher quality products, or
because of better service, and even their big discounting scheme has not
paid off and been able to bring the patients to them. So, now they are
contracting with insurance companies to take that choice away from the
amputees, and FORCE them to go to a Hanger office.
I know that the ACA receives a lot of money from Hanger, and for that there
are ads in every issue. The ACA is supposed to be there to be the
advocate for the amputees, which I would guess means to help the amputee
get education in this area, also to help them get the best care possible, to
find a good prosthetist that can help them with their needs, etc. But, with
Hanger now taking the freedom of choice away from the patients, how can the
ACA explain this one? What will it take for the ACA to stand up against
Hanger and let them know that this practice is damaging to the O&P world, to
the amputees and brace users? Do the people at the ACA really know what
this Linkia situation is doing to the people out there?
I sent an email to the ACA a couple weeks ago expressing my concerns with
this issue, and how they continue to put ads in every InMotion magazine, but
yet do things, like this Linkia issue, which does nothing but HURT the
amputees out there.
So, the answer to the question that was asked in the original email about if
this is happening anywhere else but southern Florida is that it is a
nationwide issue. The amputees and brace users that have Cigna should be
outraged and should stand up and fight against them. They should force
their employers to get a different carrier for them, go to a different
insurance company. That would be the best thing to happen, if Cigna would
lose thousands of clients and businesses over this issue. That might send a
message that this population will stand up and fight and maybe make a
difference in the insurance situations.
We all need to be aware of what is going on here. We all need to understand
what certain people in this field are doing, how if affects us, the
amputees, and everyone. We also need to realize what other ties these
people have, what affiliations they have. For example, the Hanger people
that are doing this Linkia deal, they also sit on governing bodies of the
field, like AOPA for one. Should we support an agency or organization like
AOPA when the board of directors are involved in schemes like this? That is
up to each one of us to decide for ourselves.
And, another thing to think about, with all this crap going on within our
relatively small profession, we wonder why we are getting nowhere with
legislation, and why this field seems to be self destructing. Who is
helping this field fall apart? Why can't our governing bodies and
organizations do anything to protect this field and the quality of care that
the amputees are getting out there? Hmmm...it makes one wonder.
So, everyone beware out there, and rest assured that the President of Linkia
promised me that they are only looking out for all of us. They are there to
help us and protect us. Their goal is to have EVERY insurance company go
through them to have ONE company that will administrate ALL the O&P care
that is needed in the US. What a great concept, to have Hanger control ALL
the affairs of every amputee out there.
As an amputee, if that actually happened, I would have to find another
country to move to in order to find a decent company to make a leg for me.
Any suggestions out there from the Non-USA members? Also, I will be needing
a job somewhere too. I will NOT work for Hanger ever again. That was the
worst job, and the lowest paying job I have ever had since graduation from
college.
Now that I have managed to offend several people out there, I guess I will
end my comments. If anything I said was offensive to you, you probably
should be offended and ashamed of what you are doing.
Jim DeWees, CP
>From: Gerardo Hernandez
>Reply-To: <Email Address Redacted>
>To: <Email Address Redacted>
>Subject: [OANDP-L] Linkia and Managed Care
>Date: Mon, 24 Jul 2006 18:10:45 EDT
>
>Dear Members:
>
>I simply wanted to put out there that Cigna has dropped contracts with all
>of
>its providers (in South Florida at least) and is now using LINKIA as their
>exclusive provider for O and P services.
>
>Are any other areas of the country experiencing the same thing, or this is
>phenomenon isolated to our area alone?
>
>Also, are any privately owned practices affiliated with the LINKIA Network
>of providers? Their website says to contact them about inclusion in their
>network.
>
>I look forward to hearing responses and dialogue on this issue. It is
>going
>to be very interesting what other managed care companies will be doing in
>the
>future and if they will follow.
>
>Thanks for your input.
>
>Hernan Luna, CPO, LPO
>
>Allied Orthopedics, Inc.
>1460 West 68 St. #101
>Hialeah, FL 33014
>(305) 828-3090 Phone
>(305) 828-5090 Fax
>www.alliedorthopedics.com
>
>
I really think that the solution to these problems with closed door insurance companies is the Any Willing Provider Law. Since it's taken effect in Arkansas, insurance companies have been forced to deal with us little guys. They may not send the check directly to you, the patient instead, but you will get paid. I know that it's taken effect in Kentucky where it originated, I'm not sure from our KY people how it's worked there, I'd like to hear from some of them.
We all know that Hanger has created Linkia, I believe it was 3 years ago. If they act as an insurance company and not as a burial policy type of fund, they would be forced to abide by the Any Willing Provider Law.
I personally feel that we need to get AOPA involved in creating a national Any Willing Provider Law policy that can be handed down to each state orginization. The states can then follow thru.
M. Britt Spears CPO
www.Prosthetics-Orthotics.net
Jim DeWees < <Email Address Redacted> > wrote:
I posted an email about Linkia a few weeks ago, I got a huge reaction from
the list, I received many emails from people, all of them very concerned and
frustrated with this situation.
I also got a phone call from the president of Linkia, spent a good hour on
the phone with her about my concerns. We really got nowhere with the
conversation, she tried to pacify me and lead me to believe that Linkia was
only looking out for the best interest of this field, and also looking out
for me as well. I had to laugh at that comment.
As I stated in the last posting, I called Linkia and asked for information
on finding a prosthetist in my zip code or somewhere close. The closest
provider they could offer was about 50 or 60 miles north of me, which is a
Hanger office. I asked if there were any non-Hanger facilities in the area,
and I was told that Hanger was the only facility that was qualified or
trained to do prosthetics in the area.
I also called the number to ask about how I can get in the network and be a
provider (not that I really would accept the low payment and the DEEP
discount that they are offering or allowing under the Cigna plan) and I was
told that I was not able to be in network, they have enough providers
already and were not accepting any new ones.
I called someone higher up the chain, and he told me that they could take my
name and information and when they decided to expand the network then they
might consider letting me be a provider. But as of now (and since their
beginning about 3 years ago now) they are not allowing anyone else into the
network.
I find it very, VERY, interesting that Hanger has supposedly helped fund the
ACA in the fight for parity legislation, which I understand would force
insurance companies to pay equal to or greater than the Medicare allowables,
and not have annual caps or lifetime caps. But, then Hanger, working under
the name of Linkia, has a fee schedule that is deeply cut way below the
Medicare allowables. In fact, Hanger is notorious for going way under
everyone else whenever there is a competitive fee schedule that is being
negotiated. I know this happens, I unfortunately had the experience of
working for Hanger for a long time...8 months...until I had to quit and walk
out due to major ethics issues with the management. That was in Las Vegas,
NV in 2000. I would not do the things that I was being told to do, all for
one big reason...to increase the profit margin and make more money. I know
what the discounts were for many of the insurance contracts there, I got to
see that. It was totally disgusting.
So, why is Hanger spending the time and money to help support this parity
legislation, and then on the other hand, turn around and not only offer huge
discounts to insurance companies just to get a contract? And, on the bigger
issue, now they own an administration group that is also based on HUGE
discounts.
The tougher issue here is: what does this kind of situation do to the
amputees out there? What if the amputee absolutely hates the Hanger office
in their area? What if they do not want to go there for various reasons?
Well, if they have Cigna, that's just tough crap.
Hanger, in many locations...ok, most locations, has not been able to lure
the patients into their offices because of higher quality products, or
because of better service, and even their big discounting scheme has not
paid off and been able to bring the patients to them. So, now they are
contracting with insurance companies to take that choice away from the
amputees, and FORCE them to go to a Hanger office.
I know that the ACA receives a lot of money from Hanger, and for that there
are ads in every issue. The ACA is supposed to be there to be the
advocate for the amputees, which I would guess means to help the amputee
get education in this area, also to help them get the best care possible, to
find a good prosthetist that can help them with their needs, etc. But, with
Hanger now taking the freedom of choice away from the patients, how can the
ACA explain this one? What will it take for the ACA to stand up against
Hanger and let them know that this practice is damaging to the O&P world, to
the amputees and brace users? Do the people at the ACA really know what
this Linkia situation is doing to the people out there?
I sent an email to the ACA a couple weeks ago expressing my concerns with
this issue, and how they continue to put ads in every InMotion magazine, but
yet do things, like this Linkia issue, which does nothing but HURT the
amputees out there.
So, the answer to the question that was asked in the original email about if
this is happening anywhere else but southern Florida is that it is a
nationwide issue. The amputees and brace users that have Cigna should be
outraged and should stand up and fight against them. They should force
their employers to get a different carrier for them, go to a different
insurance company. That would be the best thing to happen, if Cigna would
lose thousands of clients and businesses over this issue. That might send a
message that this population will stand up and fight and maybe make a
difference in the insurance situations.
We all need to be aware of what is going on here. We all need to understand
what certain people in this field are doing, how if affects us, the
amputees, and everyone. We also need to realize what other ties these
people have, what affiliations they have. For example, the Hanger people
that are doing this Linkia deal, they also sit on governing bodies of the
field, like AOPA for one. Should we support an agency or organization like
AOPA when the board of directors are involved in schemes like this? That is
up to each one of us to decide for ourselves.
And, another thing to think about, with all this crap going on within our
relatively small profession, we wonder why we are getting nowhere with
legislation, and why this field seems to be self destructing. Who is
helping this field fall apart? Why can't our governing bodies and
organizations do anything to protect this field and the quality of care that
the amputees are getting out there? Hmmm...it makes one wonder.
So, everyone beware out there, and rest assured that the President of Linkia
promised me that they are only looking out for all of us. They are there to
help us and protect us. Their goal is to have EVERY insurance company go
through them to have ONE company that will administrate ALL the O&P care
that is needed in the US. What a great concept, to have Hanger control ALL
the affairs of every amputee out there.
As an amputee, if that actually happened, I would have to find another
country to move to in order to find a decent company to make a leg for me.
Any suggestions out there from the Non-USA members? Also, I will be needing
a job somewhere too. I will NOT work for Hanger ever again. That was the
worst job, and the lowest paying job I have ever had since graduation from
college.
Now that I have managed to offend several people out there, I guess I will
end my comments. If anything I said was offensive to you, you probably
should be offended and ashamed of what you are doing.
Jim DeWees, CP
>From: Gerardo Hernandez
>Reply-To: <Email Address Redacted>
>To: <Email Address Redacted>
>Subject: [OANDP-L] Linkia and Managed Care
>Date: Mon, 24 Jul 2006 18:10:45 EDT
>
>Dear Members:
>
>I simply wanted to put out there that Cigna has dropped contracts with all
>of
>its providers (in South Florida at least) and is now using LINKIA as their
>exclusive provider for O and P services.
>
>Are any other areas of the country experiencing the same thing, or this is
>phenomenon isolated to our area alone?
>
>Also, are any privately owned practices affiliated with the LINKIA Network
>of providers? Their website says to contact them about inclusion in their
>network.
>
>I look forward to hearing responses and dialogue on this issue. It is
>going
>to be very interesting what other managed care companies will be doing in
>the
>future and if they will follow.
>
>Thanks for your input.
>
>Hernan Luna, CPO, LPO
>
>Allied Orthopedics, Inc.
>1460 West 68 St. #101
>Hialeah, FL 33014
>(305) 828-3090 Phone
>(305) 828-5090 Fax
>www.alliedorthopedics.com
>
>
Citation
M. Britt Spears CPO, “Re: Linkia and Managed Care,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/226913.
