June 29, 2007
Dear Cigna Patient:

During the upcoming period of “Open Enrollment” we feel obligated to inform you that unless Cigna is open to renegotiations, North Scottsdale Family Medicine may not be in Cigna’s Provider Network after January 1, 2008. Since you’ve told us that your insurance selection is decided by our participation, we wanted you to know that we participate in many other plans giving you many insurance options. We cherish our physician/patient relationship, but Cigna’s painfully unfriendly claims processing system and their refusal to adjust our reimbursement rates make it impossible for us to keep up with our ever-rising costs.

Perhaps you too, like us, have had double-digit premium hikes, large out-of-pocket deductible increases, and bigger co-pays for health insurance coverage during the last 10 years. Who’s getting this money? It’s not your physician! Some insurance companies (particularly ones with large marketing and public relations budgets) like to blame physicians who ask for reimbursement increases as the “bad guys” that make your premiums go up. This is simply not true. The facts are, while Cigna’s premiums have skyrocketed, reimbursements have not. We have endured years of increased business expenses, yet Cigna pays us less than Medicare and AHCCCS (Arizona's Medicaid program). Is this fair to us when Cigna has increased your premiums drastically every year during the last several years?

You might also hear how insurance companies are “doing their best to keep your premiums low by refusing to give in to physicians’ demands for large reimbursement increases.” This is pure hypocrisy. Insurance companies have reaped millions of dollars in profits year after year. We have only asked Cigna for a long overdue modest increase to meet our rising expenses. Despite our best cost-cutting efforts, our expenses continue to rise. Our medical and office supplies have increased 10%-25% each year for the last 10 years. Our biggest non-reimbursable expense is our personnel. It is getting more and more difficult to find the best staff at wages that we had been paying even two years ago. The fact is that wages are being driven higher because healthcare workers need to have specific training and the healthcare industry is very stressful and demanding, thus creating high turnover.

Please don’t let insurance companies blame physicians for your increased premiums! They raise their premiums to cover their “increased” costs, but healthcare providers continue to receive lower and lower reimbursements. That goes against basic economic theory. There are few businesses that can operate under conditions of increased expenses and decreased revenue. Many physicians across the country have either retired early, ceased participation with all health insurance, or closed their doors entirely.

Finally, Cigna’s tactic to delay and/or refuse an increase to us is to compare their reimbursement rates to Medicare. Cigna does not use Medicare’s rates to calculate your premium, so why are they using it to calculate our reimbursement rate? Interestingly, Medicare pays quicker, provides less claims hassles, requires fewer pre-certifications, has a more robust specialist network for the patient’s convenience, AND their premiums are usually lower.

This practice has and always will be committed to providing quality care to you, and we are trying diligently to renegotiate our contract with Cigna so as to not interrupt the relationship you have with your physician. During this time, we have decided not to accept any New Patients who are insured with Cigna because we do not want to inconvenience these patients IF we terminate our Agreement.

If you have questions or concerns regarding this matter, or just want to voice your support for our continued Cigna participation, we encourage you to speak with your Human Resources/Benefits Department or Cigna’s Member Services Department at 1-800-244-6224.

Thank you for the confidence you have placed in us.

Sincerely,

Charlene Burgett, M.S., CMA, CMM, CPC, CCP, CMSCS
Administrator