If you’ve been delisted by an insurance company, it’s important to inform patients promptly. Delisting means the insurer will not reimburse patients for services provided by that practitioner. In some cases, an entire clinic or some of its practitioners may also be delisted, which affects coverage for anyone treated at that location.

Here are some tips for communicating this type of information:

• Notify patients promptly: Inform affected patients as soon as possible, ideally before their next appointment. Use clear, simple and neutral language.
• Use factual language: For example, “As of [date], I am no longer a participating provider with [Insurance Company]. Services may not be eligible for reimbursement under your plan.”
• Avoid misleading claims: All advertising must be factual, verifiable and not misleading. Do not suggest in your advertising that coverage is available under all insurance plans.
• Provide receipts: Continue to issue receipts for all treatments, even if direct billing is no longer available. Patients may still submit claims manually, depending on their plan.
• Respect patient choice: Be prepared to discuss alternative payment options or refer patients to other providers if needed.

For further guidance, RMTs/MTs are encouraged to consult both the guide to Record Keeping, and the guide to Advertising, Communication (Standard), Code of Ethics, Fees and Billing (Standard) and email the Practice Specialist at practicespecialist@cmto.com.