ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

The Opt-Outs: Otolaryngologists extol the benefits of third-party independence

by RIchard Quinn • September 3, 2010

  • Tweet
  • Email
Print-Friendly Version

When describing to the curious the benefits of opting out of both Medicare and private insurance, Gerard J. Gianoli, MD, president of The Ear and Balance Institute in Baton Rouge, La., often recalls one particular example: During one 90-day global period about five years ago, after an eight-hour resection of a skull-based glomus tumor, post-operative ICU care and several days of inpatient care and the usual post-operative office visits, he received a total reimbursement of $500.

You Might Also Like

  • Getting out of the Insurance Game
  • AMA’s Opt-Out Provision for Sale of Physician Prescribing Data Seen as First Step
  • Situation Critical: Otolaryngologists See Diminishing Returns for Taking Emergency Call
  • A New Game Plan: Otolaryngologists and consultants devise solutions to ride out the recession
Explore This Issue
September 2010

“I don’t even think that covered the malpractice portion of my premium on that case,” said Dr. Gianoli, clinical associate professor of pediatrics and otolaryngology–head and neck surgery at Tulane University School of Medicine and an ENT Today board member.

Dr. Gianoli’s case for “opting out” may be more persuasive than ever in the current landscape, as more and more physicians, otolaryngologists included, consider operating practices that accept no private insurance or Medicare, known more formally as third-party-free practices. The conversation has percolated in recent years, but the concept seems to have drawn even more attention in the wake of the health care reform debate, with physicians who accept insurance and Medicare fearing reduced reimbursements. To wit, the Association of American Physicians and Surgeons (AAPS), whose website includes how-to guides on opting out of managed-care contracts, has seen record numbers of online visitors in the past year. AAPS has also sold out two one-day seminars this year aimed at educating physicians on their opt-out options.

“When I first mentioned this to my colleagues, they said I was crazy and it wouldn’t work,” Dr. Gianoli said. “Now, many of those same people are asking me how they can do what I did … there is a growing tide of interest in what we are doing.  I am asked to lecture on the topic, and many physicians call or e-mail asking for details.”

Jane Orient, MD, executive director of the AAPS, believes the third-party-free concept will become even more appealing as the government and private carriers ramp up efforts to recoup money improperly paid out, an initiative driven by the Centers for Medicare and Medicaid Services’ Recovery Audit Contractor (RAC) program.

In that vein, otolaryngologists considering opening a third-party-free practice from scratch or transitioning their current practice may wonder if the swap works on a variety of levels. The resounding answer from those who have done it: with a few common sense tweaks to practice management, absolutely.

Opt-Out Otos

Gerald Gianoli, MD, PCName: Gerald Gianoli, MD, PC
Opt-out date: 2005
Why: “I work for my patients. I don’t work for the insurance companies.”

Pages: 1 2 3 4 5 | Single Page

Filed Under: Departments, Health Policy, Practice Management Tagged With: billing and coding, healthcare reform, insurance, legal, malpractice, Medicare, opt-out, practice management, reimbursement, third-partyIssue: September 2010

You Might Also Like:

  • Getting out of the Insurance Game
  • AMA’s Opt-Out Provision for Sale of Physician Prescribing Data Seen as First Step
  • Situation Critical: Otolaryngologists See Diminishing Returns for Taking Emergency Call
  • A New Game Plan: Otolaryngologists and consultants devise solutions to ride out the recession

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Otolaryngologists Have a Major Role to Play in Treating COVID-19 Long-Haulers
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.