Linkia phone calls, building network
Jim DeWees
Description
Collection
Title:
Linkia phone calls, building network
Creator:
Jim DeWees
Date:
10/11/2006
Text:
To those that are following the Linkina/Hanger/SPS issue:
I just got a call from a rep at Linkia, trying to get me to sign an
agreement with them to join the network. I asked her for some prices, and
she could not give them to me until I signed the agreement. I asked her if
the prices were that bad that she was embarrassed to tell me what they were,
or what the problem is. Or was I being suckered into signing a contract
before knowing what was in it.
She finally told me what the reimbursement for 2 codes was, and because I am
probably NOT allowed to share that here on this list, I can say it was
between 35% and 40% BELOW medicare in my state. I congratulated her for
getting the prize for being one of the lowest payers in the state, even
below MEDICAID!!! And, then to top that off, they would only pay the 80% of
the allowed, if that was the patients benefits, and I wonder if they still
have customers that only have 50% coverage, I did not ask that question.
What a loss that would be to basically do charity work and take a loss on a
claim, only so that Hanger would benefit and make the money. Nice business
strategy, they can put us all out of business eventually if we take a loss
on every service we provide.
I then asked if ABC Accreditation is required, and she said it was NOT
required at this point, and that any person wanting to join the network
would not be required to have accreditation or certification. I again had a
wow response to this, and asked her if they were THAT desperate that they
would just allow ANYONE to join in, and how in the world could they ever
just let anyone join in with NO certification or accreditation. I thought
that was one of their big advertising and seeling point, that they would
have only the highest quality standards and requirements by going to this
network. (On a side note, Point Source is still in the Cigna network at the
request of Cigna, and they DO require ABC Facility accreditation, and also
cerfitication, and their reimbursement rates are a LOT higher than what
Linkia is offering....I am NOT affiliated with Point, I am not on their
payroll or have anything to gain by saying this).
So, what is going on here? Maybe it is due to some legal activities going
on that they are scrambling to get people other than HANGER facilities in
the network.
If anyone knows of the legal actions that are going on here, please advise
us and fill us in on what is going on. I have gotten some information about
the legal battles that Hanger is involved with over stock trading, the
medicare issues in New York, and the OIG being on them, etc. But I don't
have any credible information about what is going on with Cigna and Linkia.
Something must be going on for them to be offering this enrollment with no
credentials or anything.
We all need to really think about what impact this will have on the field if
we join this network, or any other network similar to this one. Are we
going to help them build a network that can eventually end up eliminating
the competition, which has been a huge discussion lately. I cannot make any
comment on what anyone in this field should do, only pose the question and
let everyone out there think about it on their own and make their own
choice. I know what my answer to this is.
I know what Cigna has paid in the past, and I also know what Cigna pays if
you are through another network, like Point, which all I can say is they pay
a LOT more than what Linkia is offering. I went back over a few of the
claims that I have filed with Cigna, and saw what they paid during the past
2 years. Now, through Linkia, the prices have dropped about 40%. How is
this good for anyone out here, especially the amputees??!!
From what I can gather from all this is, Cigna must still be allowing the
same amounts, but they give the money to Linkia first, and then Linkia keeps
whatever they can get away with, or what we will tolerate. They keep the
rest. That is the ONLY way Linkia can make any money.
We need to all look towards the next Hanger quarterly meeting, which is in a
few more days. We need to see how much Linkia has made in this last
quarter, and see what they project the dollars to be in the upcoming
quarter. Just remember, Linkia does not fabricate anything, they do NOT
produce anything, they do NOT see patients, the do NOT DO ANYTHING to make
any money. The ONLY way they can make money is by skimming money off each
claim that gets processed. They only make money by stealing a portion of
the payment that Cigna has paid for a device or service, and that is money
that should be paid to the actual provider, and NOT SOMEONE THAT DOES NO
WORK or provide any services.
We need to talk about this with everyone in every area of the country. We
CANNOT make any plans of boycotting anything, or cannot do anything like
that at all. But, we can talk to each other, educate each other, even if
the other facilities in your areas and not your friends, you need to talk to
them, because they are probably not on this list serve and may not even have
clue as to what is going on here.
Heaven forbid if we would expect any organization (ABC, AOPA, the Academy,
etc) to educate us on this matter, after all, they are all filled with
people from Hanger that run these programs. And, even the ACA, after their
big InMotion magazine publication a month or so ago which harped for several
pages about these evil insurance companies, and what we were all fighting
against (speaking as an amputee), they still will NOT SAY ANYTHING to warn
people about any group like Linkia, and just keep a very low profile on this
issue. Why? I don't know, maybe they need the money from Hanger so badly
that they will just ignore this problem.
On another topic that I mentioned in my last post, about SPS. I got many
emails, lots and lots or emails, supporting what I was saying, and several
from Hanger employees themselves. They have asked me to keep the remarks
and identities private, which I have always honored.
One of these emails explained that there is a lot of information and data
that is collected by SPS, which only makes sense after I started thinking
about it. SPS/Hanger can learn and collect information on geographic areas,
where there are high volumes of sales. If there are lots of sales in some
area, that must mean there must be a lot of amputees, and therefore, a great
place for Hanger to go and open up an office. Another person sent me an
email about how they had bought everything from SPS for years, not thinking
about who owns it, etc. Then, all of the sudden, there was a Hanger office
just around the corner from them, and they went out to conquer the area,
giving great little gadgets and gifts to all the doctors offices, and tried
to get the referrals. It worked for a while, and then the patients and
doctors realized that the prosthetic devices were made using the cheaper
components, and the patients lost that personal element with the
practitioners.
So, if you are wanting to give all your data about how many patients you are
working with, and give the competition all your information about your
business, then just go right ahead and buy everything from a vendor that is
owned by the company that wants to be in total control of the market. That
is certainly not something that I would want to do with my office and
business, give any information away that might entice them to come and open
up next door.
Again, everyone needs to call the other facilities in the areas, discuss the
future of O&P, educate each other on the issues: parity, licensure, medicare
changes, managed care contracts, vendors, etc. Do not discuss anything that
would be illegal, like price fixing, boycotting, etc.
We can leave all the price fixing discussion to the insurance companies, and
to 3rd party administration groups, because for some reason it is legal for
them to do, but not us, or at least that is what it seems.
Good luck out there.
Jim DeWees, CP
I just got a call from a rep at Linkia, trying to get me to sign an
agreement with them to join the network. I asked her for some prices, and
she could not give them to me until I signed the agreement. I asked her if
the prices were that bad that she was embarrassed to tell me what they were,
or what the problem is. Or was I being suckered into signing a contract
before knowing what was in it.
She finally told me what the reimbursement for 2 codes was, and because I am
probably NOT allowed to share that here on this list, I can say it was
between 35% and 40% BELOW medicare in my state. I congratulated her for
getting the prize for being one of the lowest payers in the state, even
below MEDICAID!!! And, then to top that off, they would only pay the 80% of
the allowed, if that was the patients benefits, and I wonder if they still
have customers that only have 50% coverage, I did not ask that question.
What a loss that would be to basically do charity work and take a loss on a
claim, only so that Hanger would benefit and make the money. Nice business
strategy, they can put us all out of business eventually if we take a loss
on every service we provide.
I then asked if ABC Accreditation is required, and she said it was NOT
required at this point, and that any person wanting to join the network
would not be required to have accreditation or certification. I again had a
wow response to this, and asked her if they were THAT desperate that they
would just allow ANYONE to join in, and how in the world could they ever
just let anyone join in with NO certification or accreditation. I thought
that was one of their big advertising and seeling point, that they would
have only the highest quality standards and requirements by going to this
network. (On a side note, Point Source is still in the Cigna network at the
request of Cigna, and they DO require ABC Facility accreditation, and also
cerfitication, and their reimbursement rates are a LOT higher than what
Linkia is offering....I am NOT affiliated with Point, I am not on their
payroll or have anything to gain by saying this).
So, what is going on here? Maybe it is due to some legal activities going
on that they are scrambling to get people other than HANGER facilities in
the network.
If anyone knows of the legal actions that are going on here, please advise
us and fill us in on what is going on. I have gotten some information about
the legal battles that Hanger is involved with over stock trading, the
medicare issues in New York, and the OIG being on them, etc. But I don't
have any credible information about what is going on with Cigna and Linkia.
Something must be going on for them to be offering this enrollment with no
credentials or anything.
We all need to really think about what impact this will have on the field if
we join this network, or any other network similar to this one. Are we
going to help them build a network that can eventually end up eliminating
the competition, which has been a huge discussion lately. I cannot make any
comment on what anyone in this field should do, only pose the question and
let everyone out there think about it on their own and make their own
choice. I know what my answer to this is.
I know what Cigna has paid in the past, and I also know what Cigna pays if
you are through another network, like Point, which all I can say is they pay
a LOT more than what Linkia is offering. I went back over a few of the
claims that I have filed with Cigna, and saw what they paid during the past
2 years. Now, through Linkia, the prices have dropped about 40%. How is
this good for anyone out here, especially the amputees??!!
From what I can gather from all this is, Cigna must still be allowing the
same amounts, but they give the money to Linkia first, and then Linkia keeps
whatever they can get away with, or what we will tolerate. They keep the
rest. That is the ONLY way Linkia can make any money.
We need to all look towards the next Hanger quarterly meeting, which is in a
few more days. We need to see how much Linkia has made in this last
quarter, and see what they project the dollars to be in the upcoming
quarter. Just remember, Linkia does not fabricate anything, they do NOT
produce anything, they do NOT see patients, the do NOT DO ANYTHING to make
any money. The ONLY way they can make money is by skimming money off each
claim that gets processed. They only make money by stealing a portion of
the payment that Cigna has paid for a device or service, and that is money
that should be paid to the actual provider, and NOT SOMEONE THAT DOES NO
WORK or provide any services.
We need to talk about this with everyone in every area of the country. We
CANNOT make any plans of boycotting anything, or cannot do anything like
that at all. But, we can talk to each other, educate each other, even if
the other facilities in your areas and not your friends, you need to talk to
them, because they are probably not on this list serve and may not even have
clue as to what is going on here.
Heaven forbid if we would expect any organization (ABC, AOPA, the Academy,
etc) to educate us on this matter, after all, they are all filled with
people from Hanger that run these programs. And, even the ACA, after their
big InMotion magazine publication a month or so ago which harped for several
pages about these evil insurance companies, and what we were all fighting
against (speaking as an amputee), they still will NOT SAY ANYTHING to warn
people about any group like Linkia, and just keep a very low profile on this
issue. Why? I don't know, maybe they need the money from Hanger so badly
that they will just ignore this problem.
On another topic that I mentioned in my last post, about SPS. I got many
emails, lots and lots or emails, supporting what I was saying, and several
from Hanger employees themselves. They have asked me to keep the remarks
and identities private, which I have always honored.
One of these emails explained that there is a lot of information and data
that is collected by SPS, which only makes sense after I started thinking
about it. SPS/Hanger can learn and collect information on geographic areas,
where there are high volumes of sales. If there are lots of sales in some
area, that must mean there must be a lot of amputees, and therefore, a great
place for Hanger to go and open up an office. Another person sent me an
email about how they had bought everything from SPS for years, not thinking
about who owns it, etc. Then, all of the sudden, there was a Hanger office
just around the corner from them, and they went out to conquer the area,
giving great little gadgets and gifts to all the doctors offices, and tried
to get the referrals. It worked for a while, and then the patients and
doctors realized that the prosthetic devices were made using the cheaper
components, and the patients lost that personal element with the
practitioners.
So, if you are wanting to give all your data about how many patients you are
working with, and give the competition all your information about your
business, then just go right ahead and buy everything from a vendor that is
owned by the company that wants to be in total control of the market. That
is certainly not something that I would want to do with my office and
business, give any information away that might entice them to come and open
up next door.
Again, everyone needs to call the other facilities in the areas, discuss the
future of O&P, educate each other on the issues: parity, licensure, medicare
changes, managed care contracts, vendors, etc. Do not discuss anything that
would be illegal, like price fixing, boycotting, etc.
We can leave all the price fixing discussion to the insurance companies, and
to 3rd party administration groups, because for some reason it is legal for
them to do, but not us, or at least that is what it seems.
Good luck out there.
Jim DeWees, CP
Citation
Jim DeWees, “Linkia phone calls, building network,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/227452.
