Have you ever tried finding a provider on a list from a PPO, HMO, Public Aid or even Medicaid?? None of these provider lists are up-to-date and they are only “fixed” on an annual basis.

Ameriplan adds 150+ new providers per state (7800 new additions to the list right here - every single month), not counting all the contract renewals, contract deletions, provider information changes, etc. etc. Are you aware that, unlike the ones listed above, member services assists members in finding a provider in their area because of the fact that their list may/may not be up-to-date even though there are people in the office that work solely on this every day of the week? Are you aware that, just because you sent Michele lists “many times” that she is not just going to take your word for it, but check with the providers involved to assure the information is correct?

Are you also aware of the “budget” doctors have on discount/free patients? They set themselves a “budget” - similar to a financial budget if you wish - because if all their patients were discounted/free patients, they wouldn’t make any money. Let’s say a doctor/dentist sets a “budget” of 100 patients on these plans - once they reach that 100, they don’t accept additional patients, BUT they are NOT removed from the provider lists because they are still providing discounts/free services to those 100 patients, therefore, they are still a provider for that company - whether it be Ameriplan, or an HMO, PPO, Public Aid, Medicaid, etc.

A doctor or dentist is a business, too … they have to pay all the people in their office, nurses, dental hygienists, dental assistants, plus their rent, utilities, pay THEMSELVES, office supplies, medicines, etc. So, just like any other business owner, they need to make enough money to pay their “overhead” above.

Here’s an example … a dentist who has ALL his patients on discounted/free plans - let’s say he has 100 total patients - I use 100 so I don’t have to think too hard , ok? 100 patients on Ameriplan - each patient averages a NORMAL $100 rate for an office visit + services. Now, each of these patients services requires an 80% discount, meaning the dentist is making $20 per patient - any idea how many patients he would have to see each day/week/month just to pay his “overhead” expenses??

Another example … let’s say you have a job in the corporate world making $15/hour - $600/week, ok? Now, imagine all of your deductions - taxes, insurance, 401K, FSA or HSA, union dues, credit unions (whatever) etc etc were equivalent to 80% of your check - you would bring home $120 out of that total $600. How many bills can you pay - how many groceries can you purchase with that $120 for all of the work you did all week? Wouldn’t you take a look at your deductions and start “budgeting” - lower what is being taken out for your 401K, FSA or HSA, credit unions, increase the exemptions on your taxes, etc so you can bring more money home to pay your bills or purchase groceries?

Now, granted, when it comes to your paycheck, a company is not dealing with THOUSANDS of employees making changes, but the changes still do not take effect immediately - they do not take effect with your next check, but POSSIBLY the following check. My son made changes to his exemptions - he works for a large corporation - it took a month before the changes finally showed up on his check.

Now getting back to providers’ lists - I didn’t mean to get “off-track” but was just trying to show examples that everyone would understand or even “relate” to. Obviously, the corporate offices of Ameriplan or any of the companies, have the most updated information which is why we encourage our new members to call member services for assistance in finding a provider if they do not have one or if they DO have one and it is not listed.

If the member DOES have a provider that they do not want to change from (I have a doctor my family has been seeing for 26 years - do I want to change? Heck, no!) - we put through a “referral” to have that doctor added to the list. This can take up to 6 weeks - why? Yes, the referral is immediately sent to the Provider Rep in that area, but it takes time for the PR to get through to the provider - then set the first appointment with them - prepare the contract for the provider - set up another appointment to drop the contract off - then, wait for the provider to sign the contract and mail it back - then the PR can get it to the office.

Now, if the member does NOT have a provider, all they have to do like I mentioned above is call member services who helps them obtain a provider - HMOs, PPOs, Medicaid, Public Aid etc. just send their members a long list of providers and the member has to sit and call everyone and HOPE they find someone that is still taking patients - if they don’t find one on the first list, they have to call back to get another list and on and on they go until they find one themselves.

Some HMOs and PPOs provide you with a book of providers, but most have pulled away from that because by the time it is printed - it is outdated - so you have to try to find a provider online - and even those provider lists are not accurate - but you receive no help - you are on your own with these companies.

A personal experience …. my daughter’s oldest is 5 years old, so 5 years ago, she tried to get our allergist/pediatrician to be her son’s pediatrician and switch her “insurance” to Public Aid/WICK for her family. This is the doctor we have been going to for 26 years. She called his office - even went there - every single girl in the office told her “no - he’s not taking any more Public Aid/WICK patients - he has too many already.” She kept trying and trying because our entire family goes to him. One day, I had an appointment with the doctor - so I mentioned my daughter’s son - what the problem with him was, etc. etc. He agreed to see my grandson as well as my daughter’s family, of course - then, I told him her family was on Public Aid/WICK and the girls in the office refused to set appointments with her any longer because of the switch - he marched into that office and TOLD the girls to continue to see the family and add my grandson and any other children she may have. The girls in the office actually argued with him - telling him that he said “NO MORE” because they were losing so much money. He put his foot down and she and her family (and they’ve added another child since then!) do, in fact, have him as a doctor.

This doctor, too, honors Ameriplan - but does not accept NEW patients under Ameriplan. My daughter has since come off Public Aid and is now a member (of course!) and almost went through the same exact thing with the girls in the office - but her Ameriplan membership is, in fact, honored there.

Yes, this doctor is on the provider list because he DOES honor Ameriplan - and others - that some of his current patients are on, but he is not accepting NEW patients. When someone new calls the office, I have heard the girls actually say “no we don’t take …….” - whether it be Ameriplan or the others - yet they ARE honoring it with the patients already on it. I asked the girls in this particular office why they say that they do not take (whichever company it is) and they said “it’s easier to just say we don’t take their plan because when we say we are no longer accepting new patients with that (insurance/discount plan), then we end up answering all kinds of questions as to ‘why not’.”

Jane, don’t take this posting wrong - I’m not trying to argue with you - I DO believe what you are saying - just trying to help you understand why the provider list in your area - and probably others! - are not accurate … or … appear to be inaccurate.

I hope this helps a little … didn’t mean to make this so long, but it’s kind of hard to explain so people will understand …

Have a GREAT Day and a very safe and Merry Christmas!

Bobbi Prim
Regional Sales Director &
Certified Regional Trainer
Top Producer/Recruiter-2008
#7 Top Recruiter Nationwide-2008

Posted: Yesterday at 11:35am
Originally posted by ammil87

Hey Bobbie,

This seems a little out of sorts. So the provider reps for a specific area just IBOs? Is there any accountability between the provider reps and corporate to make sure that the provider reps are doing their jobs and keeping in touch with providers? THis may be the weak chain the link.

Being a Provider Rep is another way an IBO can make money - yes but there are requirements like … the IBO has to be at the RSD level and working for Ameriplan for 6 months … this is one example.

BTW … fyi … another way an IBO can make money is Group Sales, too.

Many IBOs - some of who are on my team - work solely on the PR or Group Sales and don’t do recruiting or seeking members (other than through the Group Sales portion of the business). And they are making good money at these, too. Have you ever looked into these? Both require special training, which is no biggee - I am certified to do Group Sales, too, although my other enrollments have kept me more than busy enough whereby I haven’t even had a chance to pursue this.