Special Alert For Private Practice Members - Three Rivers
Earlier in the year, NASW-NYC began receiving complaints from its members in private practice about solicitations from Three Rivers Provider Network (TRPN, www.trpnppo.com), to elicit confidential information from them. After further investigation we also learned that members of the Medical Society of the State of New York were also experiencing the same concerns. With input from NASW-NYC’s Private Practice Committee, the Chapter advocated and sent letters to the offices of NYS Attorney General Andrew Cuomo and Mr. Eric R. Dinallo, Superintendent for the New York State Insurance Department, requesting a review of the business practices of Three Rivers Provider Network and the insurance companies it represents, including United Healthcare, among others.
The letter expressed that our members have complained that they have received multiple “robo-call” telephone messages from TRPN asking for providers to share their IRS tax identification number and W9 along with other information. The Chapter communicated that members received as many as ten or twenty such messages, sometimes on a daily basis, which members found to be vague and, in some cases, intimidating, as it referred to IRS requirements. In addition, when some members responded by calling the number provided, the only option given was to submit their fax number; there was no opportunity to speak with a TRPN representative for information or clarification. There was no indication of who TRPN represented in neither the original robo-call nor the second message. Most clinicians had never before heard of TRPN and had no prior dealings with them; TRPN did not provide any indication of what insurance companies they were representing in this transaction.
Some clinicians, misled by the original robo-call and the first paragraphs of the form to believe that in completing the form they were providing TRPN with a tax ID number to comply with IRS requirements, were later surprised to discover that in completing the form they had been enrolled to accept reduced fees for their services, which had not been what TRPN originally emphasized in their telephone robo-call. It appears that TRPN misled these clinicians into signing a managed care contract.
When these clinicians discovered what had happened and found a way to contact TRPN, they were told that they must wait 90 days in order to be released from this contract, and, in the meantime, that they must accept the reduced insurance reimbursement. One clinician, who threatened to engage a lawyer, was immediately released from the contract; however, not everyone has this option.
In its letter, NASW-NYC further expressed that the TRPN robo-call message and the subsequent letter from TRPN was confusing and resulted in clinicians feeling lured into unwittingly accepting a reduced fee for their services, and then making it unnecessarily difficult for them to withdraw from this arrangement. NASW-NYC called upon the Attorney General’s Office and the NYS Insurance Department to take action to prevent TRPN and the insurance companies that they represent from continuing to solicit clinicians in this manner, to promptly release any clinicians who request to be released from the contract signed and to reimburse any clinicians who request reimbursement for the reduced insurance payments that they were paid.
Since sending the letters, NASW-NYC has received responses from the NYS Attorney General indicating that they would be beginning a review with Three Rivers and from the State Insurance Department indicating that they would investigate the case. The Chapter will keep its membership updated as any new information becomes available.