Wellness

[NAES1]

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@Shaunac wrote:

I learned the hard way that it is your responsibility to actually call the insurance company to confirm that a particular doctor qualifies under your plan.  Don't rely on anyone at the office or anything online. 

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         Excellent information, Shaunac. 

What is happening to many doctors, especially the Opthalmalogists, MD -is this: even though you are in network, they, the insurance company can remove that particular practice without notice to the Dr.. Why? I have no idea, but do know from many patients that the insured will be sent a letter weeks before the doctor knows zero of THE reason/reasons. Usually, if the name of the practice ks changed or **if one of the oldest practicing doctors retires/leaves for whatever reason** this can or will be done. I spent a lot of time & research for a patient to finally find out why his/her (eye doctor) is no longer within 'said' network. Check every one each new calendar year /or 6 months. 

FYI: The physician or the staff is -usually-the last to know. I have no idea  why this is changing, but it is all too common. 

I was told by an account manager for a larger medical practice that- all ins. Co. were beginning to be equal,i.e., becoming as stingy as the other. Call and always check to confirm if any of your doctors are still In Network. It does /or can change, unfortunately. A lot of calling is necessary; nothing is being as simple as once was...if that was ever possible?

[NAES1]

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@NAES1 wrote:

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@Shaunac wrote:

I learned the hard way that it is your responsibility to actually call the insurance company to confirm that a particular doctor qualifies under your plan.  Don't rely on anyone at the office or anything online. 

---

         ______________

         Excellent information, Shaunac. 

What is happening to many doctors, especially the Opthalmalogists, MD -is this: even though you are in network, they, the insurance company can remove that particular practice without notice to the Dr.. Why? I have no idea, but do know from many patients that the insured will be sent a letter weeks before the doctor knows zero of THE reason/reasons. Usually, if the name of the practice ks changed or **if one of the oldest practicing doctors retires/leaves for whatever reason** this can or will be done. I spent a lot of time & research for a patient to finally find out why his/her (eye doctor) is no longer within 'said' network. Check every one each new calendar year /or 6 months. 

FYI: The physician or the staff is -usually-the last to know. I have no idea  why this is changing, but it is all too common. 

I was told by an account manager for a larger medical practice that- all ins. Co. were beginning to be equal,i.e., becoming as stingy as the other. Call and always check to confirm if any of your doctors are still In Network. It does /or can change, unfortunately. A lot of calling is necessary; nothing is being as simple as once was...if that was ever possible?

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ps: if any spelling errors noted, it because I am on a small notebook...very time consuming to go back to Correct'. Thank you.

[Tinkrbl44]

I was suprised to learn that many doctors pop in and out  as "providers" at the drop of a hat.    It's entirely possible that doctors that do this might forget to tell their staff about the latest changes.   

Another thing to keep in mind .... Insurance companies have a variety of plans .... your  doctor might be  a Provider in the ABC Plan, but not the XYZ Plan for that insurance company.    You get the idea.   

Verification of coverage is a real pain in the neck ... I know this first hand, as well.