by Elizabeth Jane Brooks, LMT, BCTMB

If you have contracted with an insurance carrier there may come a time when you wish to terminate that contract. Following are some suggested steps for getting this accomplished.

1. Obtain access to your contract

When the decision has been made, you need to look at the requirements in your specific contract. If you have a copy of your contract, this is easy. For many, you will need to obtain a link from the insurance carrier with an access code to open the contract file online. Contacting your insurer’s representative, or your Provider Relations Representative (if they have one), is an effective way to do this.

2. Locate termination requirements

Once you have your contract, locate the section on terminations to find the exact requirements. Some things you need to know are:

    Do you need to send a certified letter?

    What needs to be stated in your letter?

    Where to send your letter?

    To whom should this letter be addressed?

    How much notice must be given?

Keep in mind, termination must be done in writing. For this, sending it by Certified Mail is a great way to prove the writing was both sent and received. In addition to notifying the insurance carrier, if there is an administrator for the insurance, such as Tivity/WholeHealth or Community Health Plan, they will also need to be notified.

Below is a sample letter that you can tailor to your situation and use for termination. It has not been reviewed by an attorney, however, it is what a current member used to successfully terminate their own contract. Remember, your contract will tell you exactly what needs to be included in your letter of termination.

——————————

Attn: [Department, representative, etc.]

BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED

To Whom It May Concern:

This letter constitutes notice that I am voluntarily terminating my contract with your company and all its affiliates at the earliest date allowed by the contract. [Reason for terminating.] Thank you for the many years of partnership. My NPI number is [XXXXXXXXXX].

Immediately upon the effective date of this termination, I will then be out of network with your company, and all patients in your plans will be expected to pay my out-of-network fees.

Please let me know promptly if you have any additional requirements concerning my contract termination.

Sincerely,

[Full name], LMT

——————————

WSMTA hopes you find this information useful, and we acknowledge that understanding contracts can be challenging. If you still have questions or concerns regarding terminating properly, it would be wise to consult your attorney.

We at WSMTA do our best to stay on top of the latest news in massage, especially as it relates to laws, insurance, and business. We hope you find the articles on the website helpful (mywsmta.org). We also hope that you will consider joining us as a volunteer—you will make strong connections, gain support, and be at the forefront of the massage industry!

___________________

SAVE THE DATE

Understanding Healthcare Contracts

New May TBD via Zoom

2 CE's

Excellent opportunity to consult directly with John Conniff, healthcare attorney, who provided a comprehensive review of the Regence Provider Agreement. Get your questions answered, understand provisions and requirements included, some of which are not enforceable. More information to follow. The Regence contract review can be purchased on our website.