Quote:
Originally Posted by Brendanyc
Another point I would like to bring up is that many of the doctors that visit admitted patients do not take a plethora of insurance plans. I have recently retired to TV but I am part of a "cadillac" insurance plan from NYC (I am not yet age eligible to apply for medicare.) My plan is accepted by virtually every doctor in every teaching hospital in NYC (Columbia Presbyterian, Sloan Kettering, Mt. Sinai) and yet it is not accepted here. I think we need to educate our doctors on insurance plans that do pay a higher percentage than medicare, medicaid and other Obamacare insurance companies. I'm good with carrying medicare patients as I will be one in the years to come, but I am not OK with doctors not accepting plans that could assist in carrying other services provided by Medicare and Obamicare because they just never thought to ask. I do not want to continue to pay out of service rates for doctors that would be glad to participate in a plan that they have no knowledge of... we are all transplants with different insurances and well... stories.
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Simple answer to complex question, but
1. Doctors in areas outside of where the insurance company provides services may not be eligible to join as an in network doctor.
2. Each carrier has its own complex rules for management, formulary, network of labs and consultants, thick contract, rules for claims submissions and appeals, emails, program updates that the doctor must read to stay in compliance. Why would a doctor spend the time and money to join a network when there will be so few patients with that insurance? The tiny incremental increase in patients seen is simply not worth work involved in being accepted then following all that particular carrier's rules. Some would suggest we should go to single national health insurance as an option to get beyond this problem.