Iowa practices have reported receiving a check that appears to be an insurance payment from TRPN DirectPay. The check, typically for $15 or $20, includes a restricted endorsement. This means that cashing or depositing the check automatically enrolls the clinic in TRPN’s network. Being enrolled in the network subjects the clinics to TRPN’s terms and conditions, which can be highly restrictive and unfavorable to clinics. For example, once enrolled, a clinic has agreed to:
- Process all out of network claims through TRPN DirectPay without exception, and this agreement supersedes any other form of out-of-network reimbursement;
- Be paid the lesser of 35% of billed charges, 10% off maximum allowable, or 200% of Medicare, with no exceptions allowed;
- Be reimbursed at 15% below any state or federal fee schedule;
- Pay all TRPN DirectPay’s legal costs, if the agreement is challenged in court;
- Allow TRPN DirectPay to place a lien on any receivables.
Once enrolled, the clinic is bound to the terms for three years and the agreement auto-renews. If you or your clinic receive a check from TRPN DirectPay, review the enclosed terms and conditions carefully. You should be aware that merely depositing the check subjects your organization to these terms. IMS has notified the Iowa Attorney General’s Office of the issue.