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Prefered Provider Question
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<blockquote data-quote="slsh" data-source="post: 47138" data-attributes="member: 8"><p>SRL - I'd call BCBS and ask them if docs are obligated to accept BCBS patients per the contract. Because I can be kinda slippery, I'd probably call doctor back first and say you have a different ins. co and see if that gets you in the door... but it sure does sound fishy that they ask what ins *first* and then say no.</p><p></p><p>While I understand that PPO/HMO reimbursements can be really atrocious compared to actual fees, on the other hand the docs knew what they were getting into when they signed the contract in the first place. I know that right before husband switched jobs and got better insurance, a major healthcare organization in our area (several hospitals, a gazillion docs, most of our providers in fact) cancelled the PPO contract with- our ins co, which is a major insurer in the area. We were sweating bullets big time. The reason was because of the lousy reimbursement rates.</p><p></p><p>It's been a couple of decades since I worked on the contract side of PPO/HMOs and medical providers, but back in the dark ages it was part of the contract that docs would see pts covered by the ins that they were signing the contract with.</p></blockquote><p></p>
[QUOTE="slsh, post: 47138, member: 8"] SRL - I'd call BCBS and ask them if docs are obligated to accept BCBS patients per the contract. Because I can be kinda slippery, I'd probably call doctor back first and say you have a different ins. co and see if that gets you in the door... but it sure does sound fishy that they ask what ins *first* and then say no. While I understand that PPO/HMO reimbursements can be really atrocious compared to actual fees, on the other hand the docs knew what they were getting into when they signed the contract in the first place. I know that right before husband switched jobs and got better insurance, a major healthcare organization in our area (several hospitals, a gazillion docs, most of our providers in fact) cancelled the PPO contract with- our ins co, which is a major insurer in the area. We were sweating bullets big time. The reason was because of the lousy reimbursement rates. It's been a couple of decades since I worked on the contract side of PPO/HMOs and medical providers, but back in the dark ages it was part of the contract that docs would see pts covered by the ins that they were signing the contract with. [/QUOTE]
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