Recently, we’ve sounded the national alarm regarding Three Rivers Provider Network (TRPN).*

As one provider learned the hard way, TRPN sends checks to practices that, once deposited, constitute the provider’s agreement to participate in their discount reimbursement agreement (or so TRPN claims).

The TRPN agreement is unequivocally terrible for the practice, possibly illegal, and offers zero benefits to the provider.

TRPN has been at this game since at least 2007, and has reportedly made a killing. The California Medical Association described TRPN practices as “illegal” and a “deceptive business practice.” The New York chapter of the National Association of Social Workers (NASW) issued a warning to its members. The Georgia Insurance Commissioner issued a cease-and-desist order against the network, and the IRS even raided TRPN’s offices in an unrelated case.

In other words, TRPN is nationally notorious for using its devious methods to help claims administrators like Zurich Insurance North America abscond with providers’ reimbursements — and they’ve somehow been getting away with it for years.

Below, we share how one doctor apparently extricated their practice from the toxic TRPN contract. Unsurprisingly, as other providers caught in TRPN’s “agreement” have reported, this doctor had no idea they had unwittingly entered into the contract in the first place.

Once again, we warn every provider nationwide: be watchful. TRPN is a parasite lurking under the floorboards. See the table at the bottom of this article for links to many, many examples.  

Provider Ditches TRPN — But Still Loses Revenue

As a quick recap:

1. The doctor supposedly (if unwittingly) executed the TRPN contract by depositing a $100 check from TRPN, which came with a document closely resembling an Explanation of Review (EOR).
2. Zurich reimbursed the doctor for treatment at below fee schedule rates.
3. The doctor appealed the payment reductions and informed Zurich that no discount agreement exists between the doctor and TRPN.
4. TRPN sent the doctor an email offering to “reeducate” the doctor on the TRPN agreement.
5. TRPN’s email attached the noxious “agreement,” which TRPN claims the doctor entered into by depositing the $100 check.

After being “reeducated” by TRPN, the provider’s staff sent an email to TRPN (shown below), in which the practice cried foul regarding the validity of the alleged “agreement.”

TRPN responded with the following email, offering to waive the 6 month “termination period” required by the TRPN agreement.

Subsequently, TRPN sent the provider a second email confirming that the agreement was terminated — but also informing the provider that TRPN (not Zurich) denied the provider’s payment appeals, citing the “effective agreement on file.”

In other words, TRPN clarified its intention of keeping every dime siphoned from the provider while the alleged “agreement” was in effect.

TRPN instructed the doctor that to dispute the TRPN reductions taken (by Zurich) prior to the “termination” of the agreement, the doctor must provide the “necessary information and documentation,” which includes:

• Copy of bank reconciliation for the attached cleared check
• Copy of bank custodial agreement
• Name and contact of the providers accountant and attorney
• Copy of a 12 month collection history for the same services rendered

California laws dictate the appeal mechanisms to dispute incorrect payments (which include none of the documentation TRPN listed). Yet apparently, Zurich is circumventing California law regarding this doctor’s appeals, as evidenced by TRPN’s email in which the network claims to have “denied them all.”

What can providers in California (and every other state) learn from all this?

The good news: as with any schoolyard bully demanding someone’s lunch money, there’s a fair chance TRPN will back down when confronted. Perhaps TRPN would rather not see what would happen if the TRPN agreement — and the network’s duplicitous methods of securing providers’ participation — were scrutinized in court.

The disgusting news: Claims administrators (like Zurich) and other payers apparently work with TRPN to take money from doctors, until the doctor becomes wise to the scheme. In this instance, TRPN could take a percentage of the doctor’s revenue from February 22, 2023, through July 14, 2023.

Don’t be TRPN’s next victim. Watch your incoming checks, and when TRPN comes sniffing around, inform them of exactly where they may deposit their “participation payment.” If your office accidentally deposits TRPN money, return the funds and cancel the agreement within the 90-day “safe harbor” period explained in our previous articles.

Failing that, we cannot claim with any certainty that TRPN will voluntarily release every provider who demands it, as in this case. If you find your practice in TRPN’s clutches, and the network refuses to terminate your agreement immediately, email the details to info@daisyBill.com.

In a future article, daisyBill will publish the names of all claims administrators known to have taken providers' reimbursements by citing a TRPN “agreement.” See the table below for external articles about TRPN — with a simple Google search, any claims administrator could have known that TRPN is up to no good.

Claims administrators that do business with TRPN deserve their fair share of credit for this network’s behavior.

* Correction, August 17 and 29, October 6 2023: An earlier version of this article contained a factual error regarding TRPN’s ownership that has since been corrected.

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