Dear Politicians:

It is easy to see from the newspaper and amount of emails we receive that you are waist deep in finding solutions to the many problems facing the American people.  For all your hard work and continued commitment, I thank you.  As an Arizona small healthcare practice owner for more than 20 years, I am hoping you can direct me to a source that would be able to help me with the problems we are facing here in our State.

I have worked in healthcare since 1976 and have always considered myself a patient advocate. I have never seen the types of business behavior from the insurance companies as I am seeing at present.  Following are just a few of many easily remedied problems we deal with on a daily basis:

• Insurance cards that don’t have the correct claims address. Why aren’t insurance companies required to have the correct information on their cards? Even insurance company websites don’t have current contact information.
• Hard to tell who or what network the patient is in. Example: We have seen cards from the SAME insurance Company – one being Ruby and the other Ruby Select.  We can see patients from one but not the other.
• We don’t even know what insurance we take because contracts change without notice. This should be corrected by insurance companies being forced to standardize their provider search by either Tax ID or NPI numbers.
• We have seen insurance cards with up to five different logos on them. When we as professionals cannot recognize who the primary insurance provider is, how in the world are the senior citizens who make up the majority of our practice supposed to know. It would only stand to reason that every one of these companies is getting a piece of the pie. 
• Medicare Advantage Plans have no transparency in terms of who they are; how many grievances have been filed against them; what their grievance process is; and it cannot be substantiated where their call centers are located. It is outrageous that we pay US Insurance Companies with federal dollars to take care of our seniors and we allow these same insurance companies to operate their call centers in places like the Philippines. 

We are an Arizona nurse practitioner practice that is nationally recognized as a leader in our subspecialty. However, we get paid 15% less because Nurse Practitioners are a female dominated field. Never was this discrimination more apparent than this last year when we converted our medical records and billing to Electronic Medical Records. We completed all the requirements and jumped through all the hoops only to find that we would not be reimbursed for Meaningful Use because (1) we are a Nurse Practitioner Practice and the government only fully recognizes MD practices and (2) as Nurse Practitioners we could have been recognized for a portion of Meaningful Use through our Medicaid patients but Arizona Medicaid intermediaries do not contract with Nurse Practitioners. We go above and beyond to provide the best, state of the art, cost-effective, evidence-based, pragmatic treatment possible to our patients.

Thank you for your time and hopefully help. Our website is www.cca-center.com  Our doors are always open to you and your staff to see firsthand what we are up against.

Respectfully,

Joel J. Rosen

(623) 977-1212