Doctors complain of slow pay from HMO

While the Nevada State Insurance Commission continues its investigation into PacifiCare of Nevada's business practices, physicians continue to complain that they are not getting paid.

Bob Lawrence, administrator for the Cardiovascular Center of Southern Nevada, said his practice is owed in excess of $1 million. Some of the claims, he said, date back to 1996 and 1997.

Dr. Ivan Goldsmith of the West Tropicana Medical Centre said he's seeing more PacifiCare patients and getting paid less money. For the month of June, he treated 2,279 patients and received $15,284 from the health maintenance organization. In July, he treated 2,951 patients and got $13,185.

"Our enrollments are going up and our checks are going down," an angry Goldsmith said. "They (PacifiCare) play a game of bureaucracy to slow down payments."

PacifiCare says the problems stem from its association with the management company, FPA Medical Management Inc., which was suppose to pay the doctors. The HMO terminated its contract with FPA on July 3 and is now handling payments itself.

"As with all of our providers, Dr. Goldsmith is an important provider to us, and we don't want to be at odds with him and his practice," said Kayla Callas, director of public affairs for PacifiCare of Nevada. "We have 69,000 members out there. We would hope that our providers would work with us through this transitional period."

Peggy Deal of the Insurance Commission said concerned consumers should call the commission offices at: Las Vegas, 486-4009; Carson City, (702) 687-4270; and statewide at 1-888-872-3234.

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