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Physician Support Keeps Our Network Strong
Dr. Brad Drexler

The strength of the PFMC network includes advantages to physicians that not all members know about. In a recent interview, PFMC board member Dr. Brad Drexler touched on some of them.

The PFMC physician network was formed in Sonoma County in 1957. Many physicians have been members of PFMC for a long time, and that is a strength, along with the fact that PFMC is a large and broad network. Some health plans have had trouble providing certain specialty areas of care—GI, for example—making referrals difficult for both doctors and patients. This has not been a problem for PFMC.

This network is also well run and very physician-friendly. Physicians are reimbursed reasonably.

Another strength, which some members may not know about, is that the network generates income for medical- and health-related grants. We are actively soliciting new grants from health programs throughout the PFMC network area.

I think PFMC deserves the support of both individual physicians and the regions served by the network. We can show our support by encouraging colleagues to sign up if they aren’t already members. We can also stop signing bad contracts. When I am contacted by HMOs who want me to contract directly with them, my position is to suggest that they contract with PFMC instead. I feel that I have much more bargaining power with the foundation than if I were to try to negotiate a contract by myself. In any case, the number of plans that are contracting with PFMC has been growing, and the innovative Basic Plus health plan has helped increase the number of covered lives.

I read every single contract I sign, and I think more and more doctors are doing this. It is certainly easier to have the one PFMC contract than to deal with many separate insurance contracts. I like the PFMC contract because it is reliable. When you bill for services, you’re going to get paid on a timely basis, you’re not going to get denied or downcoded, and you won’t get the runaround. In my office, we are never concerned about PFMC billings.

Problems with insurance companies affect cash flow and consume a lot of staff time. Your staff is on the front line, and patients can sense if they’re unhappy. By joining the PFMC network, I’m controlling costs and keeping my staff and patients happy—the very things that are key to running a successful practice.