I recently took over billing for a psychiatrist's office. He is out-of-network with all insurance companies. He had enrolled in Multiplan, but after seeing how much money he was losing, we recently canceled that agreement. The cancellation finally took effect 10 days ago. Around that same time, we received a discounted rate request via fax from Multiplan. They claim patient has no OON benefits unless we agree to their deep discount.
I called Multiplan who said the claim was sent to them from Cigna with a request to discount it by $113 (previously they had been discounting this fee by $90). I told them we don't want to accept this discount and they said that the request should then be faxed back as DECLINED.
The question is whether CIGNA can simply decline claim as OON if we don't accept--or can we simply say no thanks, pay in full--why should we discount? Do they have any leverage? Why would we accept discount for no reason?
EDIT: I just confirmed with Cigna that patient does have unlimited OON visits (so Multiplan id full of $%#*), that Cigna will play at 80% based on maximum allowable in the area. So I think that answers my question. I am still curious if anyone can offer any additional info about cancelling Multiplan. Thanks!
James