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WTH is up with doctors no longer taking ANY insurance?!

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justbeachy
So close....

Member since 7/07

2900 total posts

Name:

WTH is up with doctors no longer taking ANY insurance?!

So I need to go to my doctor today... I haven't gone since I moved back to NY (so it's been over 2 years).

I call for an appointment and she no longer takes ANY insurance! What the HELLL is that!? I love her and I wont change - I guess I'll suck it up - but I've never heard of such a thing! Chat Icon

Message edited 12/16/2008 10:48:17 AM.

Posted 12/16/08 10:47 AM
 

SweetTooth
I'm a tired mommy!

Member since 12/05

20105 total posts

Name:
Lauren

Re: WTH is up with doctors no longer taking ANY insurance?!

Thats crazy. I wouldn't go to a doctor that didn't take my insurance. I can't afford to pay those kind of bills out of pocket. Especially when I pay to have insurance so I don't have to do that.

Posted 12/16/08 10:50 AM
 

MsSissy
xoxoxo

Member since 3/07

39159 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

I never heard of that.

I wouldn't be able to afford going to a dr who didn't accept insurance.

I would need to find someone else.



Posted 12/16/08 10:50 AM
 

NinaLemon
It's a boy!!!

Member since 10/07

6453 total posts

Name:
Jeannine

Re: WTH is up with doctors no longer taking ANY insurance?!

I have never heard of that either! I would never go to a Dr. that did not accept insurance!

Posted 12/16/08 10:52 AM
 

ave1024
I Took The Wrong Road

Member since 12/07

6153 total posts

Name:
That Led To The Wrong Tendencies

Re: WTH is up with doctors no longer taking ANY insurance?!

If you think that's strange... check this out.

I was going to a foot doctor that took my United insurance.

Well low and behold I got a letter from my insurance company saying the doctor was not on the insurance anymore and I theoretically owe the doctor this remaining balance that insurance didn't cover.

So I call the doctor and ask why didn't you guys tell me? The doctor says they came off the insurance network because they actually get paid MORE being off the network than being on the network.

Ok so that's fine I tell them, but I also said well what about this remaining $40 dollars I owe you that insurance didn't cover. They said "don't worry about it we won't bill you for that". Chat Icon Chat Icon Chat Icon Chat Icon Chat Icon

So I ask the doctor if I can continue seeing them, file out of network claims with my insurance and I won't owe the doctor any of the remainder, they said YEP! Apparently they still make more money in this scenario. How? No clue and I am still a little shady about this.

I'd find another foot doctor but I really like this guy (after seeing five others I didn't like).

Posted 12/16/08 10:52 AM
 

DaniJude
You're My Home <3

Member since 11/06

14815 total posts

Name:
Danielle

Re: WTH is up with doctors no longer taking ANY insurance?!

A lot of docs are doing that now. I know three docs in our area, not mine, but three of them that have made the switch in the past few years -- either that or they take very few companies.

Apparently, the insurancies companies are making it so the docs aren't making any money off of the visit -- so, many docs are doing this. DH explained this to me but I don't remember the specifics - I half-listen to him when he explains stuff like that lol it is a condition called 'spousal deafness'.

What kind of doc is she??

I'm sorry that she no longer accepts insurance! Chat Icon

Posted 12/16/08 10:54 AM
 

LittleBlueBug
Happy Mommy

Member since 9/06

4074 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

That's gonna be more and more common. Doctors are not making the money w/ insurance and the pay-outs are slow.

Doctors don't make as much as people think.Chat Icon

I know it stinks, but it's going to be more and more common. People who really are attached to their physicians (people w/ health problems usually are) would rather just pay (if they are able too) than switch.

Posted 12/16/08 10:54 AM
 

Ophelia
she's baaccckkkk ;)

Member since 5/06

23378 total posts

Name:
remember, when Gulliver traveled....

Re: WTH is up with doctors no longer taking ANY insurance?!

I worked for a doctor that did not "take" insurance.

especially for a sub specialist, it really doesn't pay.

usually what happens is the doc with agree to "accept" the allowable amount of your ins IF you have out of network benefits.

if you don't, you pay privately...aka...you pay.

if the health insurance issue in this country is not addressed soon, you will see more and more doctors opting for this.

they are simply NOT reimbursed enough to cover all expenses (office, staff, malpractice, et al)

it's terrible.

Posted 12/16/08 10:57 AM
 

justbeachy
So close....

Member since 7/07

2900 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by LittleBlueBug

I know it stinks, but it's going to be more and more common. People who really are attached to their physicians (people w/ health problems usually are) would rather just pay (if they are able too) than switch.



That's me! I love my doctor. She's my primary care physician. I think she said I could still file an out of network claim....Chat Icon

Posted 12/16/08 10:58 AM
 

Ophelia
she's baaccckkkk ;)

Member since 5/06

23378 total posts

Name:
remember, when Gulliver traveled....

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by ave1024

If you think that's strange... check this out.

I was going to a foot doctor that took my United insurance.

Well low and behold I got a letter from my insurance company saying the doctor was not on the insurance anymore and I theoretically owe the doctor this remaining balance that insurance didn't cover.

So I call the doctor and ask why didn't you guys tell me? The doctor says they came off the insurance network because they actually get paid MORE being off the network than being on the network.

Ok so that's fine I tell them, but I also said well what about this remaining $40 dollars I owe you that insurance didn't cover. They said "don't worry about it we won't bill you for that". Chat Icon Chat Icon Chat Icon Chat Icon Chat Icon

So I ask the doctor if I can continue seeing them, file out of network claims with my insurance and I won't owe the doctor any of the remainder, they said YEP! Apparently they still make more money in this scenario. How? No clue and I am still a little shady about this.

I'd find another foot doctor but I really like this guy (after seeing five others I didn't like).



lemme splain Chat Icon


if you have a plan that has both IN and OUT of network benefits, the plan pays at 2 levels.

the In Network doc gets paid a certain amount for your visit, previously agreed upon.

the OUT of Network Doc is paid a PERCENTAGE of THEIR PRIVATE Rate...and the patient is responsbile for the rest (a typical 80-20 scenario) sooo

In network doc is getting $35 for the entire visit as per their contract (presumably they make their money in quantity of patients in the plan)

OUT of network doc is getting 80% of THEIR billing, so if their private rate for the SAME visit is $100, they are getting $80.

even without your $40, they STILL get more.

does that make sense?

Posted 12/16/08 11:01 AM
 

timanda
Puppy Love

Member since 6/08

1627 total posts

Name:
Amanda

Re: WTH is up with doctors no longer taking ANY insurance?!

my aunt is a chiropractor and she has stopped accepting almost every insurance because she makes almost NO money from visits and they give her a hard time about everything.

I think she was saying she gets something like $10 or $15 per visit from some insurance co's (don't quote me on it I could be wrong about the exact $ amount), which she cannot live on. She loves her patients but it is costing her to continue to see some of them. Chat Icon

Sorry the dr you love stopped taking insurance Chat Icon That suxs.

Posted 12/16/08 11:01 AM
 

GioiaMia
Let's Go Rangers!

Member since 1/07

14818 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

My derm stopped taking my insurance and I started paying LESS than what my copay was! It was so strange!

He kind of asked me to promise to keep coming to him - it was an awkward conversation.

Posted 12/16/08 11:02 AM
 

DaniJude
You're My Home <3

Member since 11/06

14815 total posts

Name:
Danielle

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by LittleBlueBug

That's gonna be more and more common. Doctors are not making the money w/ insurance and the pay-outs are slow.

Doctors don't make as much as people think.Chat Icon




This is true -- they really don't anymore! This is the MAIN reason Vin switched from going to medical school to going for his education degree. He was pre-med and took all those crazy science classes... So, he used all those science/chem/bio classes toward being a science teacher and went back for his education master's (he's almost done) -- he'll be done in May vs. being done in four years, only to do residency, only to owe eleventy billion dollars in student loans only to make NOT MUCH AT ALL -- definitely not enough to pay them off in this lifetime! It is terrible - after a while we are going to have shortage of docs, I know it, because where is the end-result of having to go to school forever, work ridiculously hard and long hours and pay a fortune in college tuition?? It won't be worth it - from a reality standpoint anymore... I mean, unless the person feels they have a moral obligation which a lot of people do but then 'how am i going to live' gets in the way, KWIM?

Posted 12/16/08 11:04 AM
 

DaniJude
You're My Home <3

Member since 11/06

14815 total posts

Name:
Danielle

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by SupaBonBon

Posted by LittleBlueBug

I know it stinks, but it's going to be more and more common. People who really are attached to their physicians (people w/ health problems usually are) would rather just pay (if they are able too) than switch.



That's me! I love my doctor. She's my primary care physician. I think she said I could still file an out of network claim....Chat Icon



I was going to guess that. This is most common with GP's.

So sorry again Chat Icon

The three that I mentioned above - two of them are GP's.

Message edited 12/16/2008 11:07:41 AM.

Posted 12/16/08 11:05 AM
 

ave1024
I Took The Wrong Road

Member since 12/07

6153 total posts

Name:
That Led To The Wrong Tendencies

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by Ophelia

does that make sense?




Yeah I figured there was some sort of money shenanigans going on.

My only issue with this is, I have nothing in writing from the doctor saying they won't bill me for the remainder at any point, in case some hotshot office manager comes in and tries to get money from a bunch of past visits and pushes the collections envelope.

Next time I'll be definitely getting something in writing if I continue to see this doctor.

Posted 12/16/08 11:05 AM
 

JP826
=)

Member since 9/06

10903 total posts

Name:
Me!! All about ME!

Re: WTH is up with doctors no longer taking ANY insurance?!

I have never heard of that! Your doc is going to be losing alot of patients!

Posted 12/16/08 11:05 AM
 

LittleBlueBug
Happy Mommy

Member since 9/06

4074 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

It's tough, but the insurance companies are making it difficult for doctors to continue to accept insurance and make a living. Any business requires some profit in order to keep operating, and they can barely cover their costs.

Not to get political on this, but this is why a government sponsored health plan won't work. Either doctors are going to leave their practices or not accept health insurance. I know that's not on the agenda now, but it's just a thought on an old debate. Some may disagree with that, and that's fine.

I know how you feel. Definitely look into it. Also ask the doctor how much she charges for appointments. It may not be too badChat Icon

Chat Icon Chat Icon Chat Icon

Posted 12/16/08 11:08 AM
 

LittleBlueBug
Happy Mommy

Member since 9/06

4074 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by SIBride06

I have never heard of that! Your doc is going to be losing alot of patients!



The amount of patients lost will not effect the income as you may think when if she saw them through insurance she wouldn't make much from them anyway. It probably would cost her more to see them than she makes from them. Insurance does not pay out full fees, usually just a percentage. More people then you may think will actually pay out of pocket. I have heard of people dishing out insane amounts of $$$ weekly because their insurance does not cover it or they don't have insurance.

Posted 12/16/08 11:12 AM
 

Kara
Now Zagat Rated!

Member since 3/07

13217 total posts

Name:
They call me "Tater Salad"

Re: WTH is up with doctors no longer taking ANY insurance?!

Does your insurance cover a percentage of out of network doctors? I have a plan that does for thi exact reason. I want to be able to choose ANY doctor I may need without having to bear the full cost of services.

Posted 12/16/08 11:13 AM
 

Lillykat
going along for the ride...

Member since 5/05

16253 total posts

Name:

Re: WTH is up with doctors no longer taking ANY insurance?!

There are many doctors out there that do this - especially one affiliated with the top hospitals in the city. I have come across a lot of them. Many of them are listed as top doctors so they have a lot of patients who want to see them b.c they are top in their field so they have patients who are willing to pay their prices. Remember most people just submit those as out of network doctors and then if you insurance covers out of network you get something back. My radiologist doesn't take insurance.

Posted 12/16/08 8:05 PM
 

Blu-ize
Plan B is Now Plan A

Member since 7/05

32475 total posts

Name:
Susan

Re: WTH is up with doctors no longer taking ANY insurance?!

Posted by Kara

Does your insurance cover a percentage of out of network doctors? I have a plan that does for thi exact reason. I want to be able to choose ANY doctor I may need without having to bear the full cost of services.



Me too. I would definitely continue to see a doctor I liked and trusted even if I had to go out of network.

Only one of the specialists I saw this year are in network. Out of network doctors also sometimes participate in multi-plan which is a plan where they negotiate the rates with the insurance company.

In network docs get your co-pay and a fee from the insurance company which is a contracted rate. My doc bills them $175 for an office visit but gets paid $65. It's on my EOB. So he makes $85 for my visit. I don't get the regular 15 minutes from him, but more. Most docs who are getting paid like this can only spend 15 minutes tops with a patient because they have to do the volume.

For this reason, I would gladly pay an out of network doc the co-insurance-mine is 70% and then submit it to my FSA for retimbursement.

It's a sad state of our healthcare system when the brightest people don't get compensated for the most important work there is. JMO..

I also feel that way for PhDs as well. I know some of the programs don't pay well at all. These are scientists!!! They should get paid!

Message edited 12/17/2008 9:09:23 AM.

Posted 12/17/08 9:08 AM
 
 

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