Concierge Medicine
Posted 11/14/11

There is a trend among some physicians in Oklahoma to move to a “concierge” practice model which is also known as a private physician practice model.

Typically, concierge medicine is a fee-for-service health care delivery system that is characterized by a direct, financial relationship between private physicians and their patients. In many cases, private practice physicians collect a retainer from their patients in addition to filing insurance claims for covered services.

HealthChoice Network Providers should be aware that charging a retainer in association with HealthChoice covered services is a violation of their Network Provider Contract. This kind of contract violation will result in the termination of the provider contract. Once contracts are terminated, all HealthChoice claims will be administered at the non-Network reimbursement rate.

If you have questions or need additional information, please call HealthChoice Provider Relations at 405-717-8790 or toll-free at 1-800-543-6044. You can also email provider relations staff at oseegibproviderrelations@sib.ok.gov.