Talk of The Villages Florida

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-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Alliant Dermatology forced TO TERMINATE UHC The Villages and AARP Med.Advantage (https://www.talkofthevillages.com/forums/medical-health-discussion-94/alliant-dermatology-forced-terminate-uhc-villages-aarp-med-advantage-265316/)

Villageswimmer 06-10-2018 06:32 AM

Quote:

Originally Posted by graciegirl (Post 1551964)
Thank you. I am still confused. We have United Health Care Insurance which is used by Dr. Casper's office. Still valid.

This is the health insurance that the Villages Health Care uses which is a small Florida Firm???? Oh please explain someone.


You may have the Supplemental as opposed to Advantage. My best guess.

graciegirl 06-10-2018 06:59 AM

Quote:

Originally Posted by Villageswimmer (Post 1551970)
You may have the Supplemental as opposed to Advantage. My best guess.

So. The Villages Health Care System is no longer using Dr. Casper. NOT MEDICARE and NOT United Health Care. Just the Villages.

He has so many patients and people waiting in line because he is GOOD. I don't think it will hurt HIM. Some People may have to buy another insurance to use him? So the petition MAY have been put in his office by disappointed patients and not HIM? He is so kind and would not say no I am sure.

Villageswimmer 06-10-2018 07:26 AM

Quote:

Originally Posted by graciegirl (Post 1551978)
So. The Villages Health Care System is no longer using Dr. Casper. NOT MEDICARE and NOT United Health Care. Just the Villages.


No. This is confusing. The best way to understand this is to read the notice on his site at the link on page one of this thread. And, yes, the petition was started by Alliant.

villagerjack 06-10-2018 07:39 AM

Quote:

Originally Posted by graciegirl (Post 1551964)
Thank you. I am still confused. We have United Health Care Insurance which is used by Dr. Casper's office. Still valid.

This is the health insurance that the Villages Health Care uses which is a small Florida Firm???? Oh please explain someone.

Gracie look at the small print on the bottom of your insurance card. If it says UNITED HEALTHCARE MEDICARE COMPLETE (HMO) you have a MEDICARE ADVANTAGE PLAN. That is the Villages Plan, not a small company. It is part of United Healthcare. This is the Plan dropping Allient. Dr Casper has not disclosed the reason his practice was dropped. It is curious that The Plan would favor one doctor over another since his patients will continue to seek care, just not with Allient. IMHO it could be one of two reasons, the cost, which may involve an abnormal number of surgeries or the type of care, remember he has a lot of new doctors. I caution you my opinion is just speculation. But before I sign any petition, I feel I am entitled to know why his practice was dropped.

Villageswimmer 06-10-2018 08:02 AM

Quote:

Originally Posted by villagerjack (Post 1551995)
Gracie look at the small print on the bottom of your insurance card. If it says UNITED HEALTHCARE MEDICARE COMPLETE (HMO) you have a MEDICARE ADVANTAGE PLAN. That is the Villages Plan, not a small company. It is part of United Healthcare. This is the Plan dropping Allient. Dr Casper has not disclosed the reason his practice was dropped. It is curious that The Plan would favor one doctor over another since his patients will continue to seek care, just not with Allient. IMHO it could be one of two reasons, the cost, which may involve an abnormal number of surgeries or the type of care, remember he has a lot of new doctors. I caution you my opinion is just speculation. But before I sign any petition, I feel I am entitled to know why his practice was dropped.

Agree, which is why I said in an earlier post that I wish Casper had posted the letter from UHC on his website. I think there may be more to this than the two reasons you mention, however.

Dan9871 06-10-2018 09:07 AM

Quote:

Originally Posted by Villageswimmer (Post 1551747)
I wish Casper had posted the letter from UHC.
.

The Alliant website says that if you stop by one of their offices you can get a copy of the UHC letter.

From the Alliant website:

" If you would like a copy of the letter we received from UHC, please stop by one of our offices to receive one. "

Dan9871 06-10-2018 09:14 AM

Quote:

Originally Posted by jojo (Post 1551872)
Yes the quotes are accurate (and I thought well known), but irrelevant to the fact that The Villages Health plan has reduced the availability of dermatologists in the network that they accept. This should be concerning to those on that Advantage plan (which we used to be).

This article When Medicare Advantage Drops Doctors, Some Members Can Switch Plans | Kaiser Health News is a couple of years old but is probably still applicable.

It basically says if your doctor's is dropped from your advantage plan you may be able to switch plans or go back to regular medicare. It's not automatic but the law was changed to allow medicare to make an exception when events like this happen so you have to check with medicare to see if you can get one.

Villageswimmer 06-10-2018 09:46 AM

Quote:

Originally Posted by Dan9871 (Post 1552024)
This article When Medicare Advantage Drops Doctors, Some Members Can Switch Plans | Kaiser Health News is a couple of years old but is probably still applicable.

It basically says if your doctor's is dropped from your advantage plan you may be able to switch plans or go back to regular medicare. It's not automatic but the law was changed to allow medicare to make an exception when events like this happen so you have to check with medicare to see if you can get one.

Very helpful info, thanks! The down side of switching, though, is you’re now out of the Villages Health System since you no longer carry UHC Advantage. It’s a slippery slope.

Marathon Man 06-10-2018 09:57 AM

Quote:

Originally Posted by Moderator (Post 1551870)
The topic of this thread is the specific change in dermatology providers by United Health Care. If you wish to start a new thread about health care plans/policies in general, please do so. Further off topic posts will be deleted.

Thank you.

Moderator

Thank you.

Marathon Man 06-10-2018 10:02 AM

Quote:

Originally Posted by villagerjack (Post 1551995)
… But before I sign any petition, I feel I am entitled to know why his practice was dropped.

An excellent point.

villagerjack 06-10-2018 02:10 PM

Quote:

Originally Posted by Dan9871 (Post 1552020)
The Alliant website says that if you stop by one of their offices you can get a copy of the UHC letter.

From the Alliant website:

" If you would like a copy of the letter we received from UHC, please stop by one of our offices to receive one. "

Seems strange especially since we have a lot of Seasonal Resudents that cannot just stop by his office. Why not put it on the Website? Casper should be calling or sending letters to all of his patients to explain why UHC prefers other Dermatologists over his practice. If I did not read TOTV I would not know that UHC HMO dropped his practice. Something very unprofessional about the way this has been handled.

l2ridehd 06-10-2018 02:24 PM

UHC is a business. They have profit goals like every business. When they miss their objectives they go to the doctors and cut costs, usually by asking them to take a lower payment for certain procedures. If the doctor refuses or can't because they just built a new building or expanded staff or some reason, then UHC will find another provider and drop them. It happens all the time.

Always remember that the doctor doing your surgery is the one who agreed with the insurance company to do it for the lowest cost.

CFrance 06-10-2018 02:42 PM

Quote:

Originally Posted by l2ridehd (Post 1552087)
UHC is a business. They have profit goals like every business. When they miss their objectives they go to the doctors and cut costs, usually by asking them to take a lower payment for certain procedures. If the doctor refuses or can't because they just built a new building or expanded staff or some reason, then UHC will find another provider and drop them. It happens all the time.

Always remember that the doctor doing your surgery is the one who agreed with the insurance company to do it for the lowest cost.

Huh. Thanks, I just learned something about doctor group business practices that I never thought of.

And is that a sailboat in your avatar?

villagerjack 06-10-2018 03:51 PM

Quote:

Originally Posted by l2ridehd (Post 1552087)
UHC is a business. They have profit goals like every business. When they miss their objectives they go to the doctors and cut costs, usually by asking them to take a lower payment for certain procedures. If the doctor refuses or can't because they just built a new building or expanded staff or some reason, then UHC will find another provider and drop them. It happens all the time.

Always remember that the doctor doing your surgery is the one who agreed with the insurance company to do it for the lowest cost.

Except we do not know that to be the case in this instance since Dr Casper has not disclosed why UHC dropped his practice and approved other providers.

(UHC dropped him, he did not drop UHC, that much seems clear. In fact, he wants to come back to UHC.)

In not publicly disclosing why he was dropped, he has caused unnecessary speculation. Some are whispering about the quality of work of his younger and newer doctors and others about the need for surgery that could be addressed in a simplier fashion. This is unnecessary and possibly damaging speculation.

BTW just because a doctor accepts a lower amount from UHC does not mean his or her work is inferior. It could very well mean that the Practice considers payments from UHC as being satisfactory to cover his costs.

Villageswimmer 06-10-2018 05:29 PM

Quote:

Originally Posted by villagerjack (Post 1552114)
Except we do not know that to be the case in this instance since Dr Casper has not disclosed why UHC dropped his practice and approved other providers.

(UHC dropped him, he did not drop UHC, that much seems clear. In fact, he wants to come back to UHC.)

In not publicly disclosing why he was dropped, he has caused unnecessary speculation. Some are whispering about the quality of work of his younger and newer doctors and others about the need for surgery that could be addressed in a simplier fashion. This is unnecessary and possibly damaging speculation.

BTW just because a doctor accepts a lower amount from UHC does not mean his or her work is inferior. It could very well mean that the Practice considers payments from UHC as being satisfactory to cover his costs.


I agree with you about the speculation and I’m sorry to see his practice suffer. But are you sure Dr. Casper hasn’t disclosed the reason by virtue of his offering to give a copy of UHCs letter upon request? Has anyone on this forum seen it?

Surely the reason for dropping him is in that letter. I still think it would have been cleaner and perhaps stifle rumors had it been posted on his site with the other document.

In his defense, I believe this is all very new. He probably never experienced a crisis like this and didn’t know how best to handle it.


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