And as scomarco said, the HMO and PPO networks are seldom identical even with the same medical system. Also the provider directory and sunfire may not be updated. Call the actual doctor's office/medical practice to see if they accept your client's insurance. It doesn't matter what the provider directory, etc says if the doctor's practice/medical system says they do not accept his insurance. Other threads people have commented on this issue as well so, unfortunately, what you are seeing is not unique.
Cigna Member | HMO Referral Issues
- Thread starter newbie2001
- Start date
Thats not what i see in the areas i work . The networks I've seen with the biggest carriers with hmo/ppo are very similar .That said i believe starting in 2026 we'll see significantly less ppo's .
Do you not get many emails from Cigna threw out the month? They show the regionals at the bottom of email
Some are the same here and some are not (although more are the same than not). Be nice if they were the same regardless of which kind (eg HMO, PPO MAP, etc.) from a carrier. That would make life a lot easier for everyone.
- Thread starter
- #15
newbie2001
Super Genius
- 202
I get a crap ton. I combed through them today and all I could find was my old regional who quit.
What state you in ?
- Thread starter
- #17
newbie2001
Super Genius
- 202
FL
"Very similar" is not the same as identical . . .
Also, threw is not even close to being the same as through.
And yes, I sometimes unblock some of the folks who have very little to contribute to the topic just to get a laugh at what they post . . . especially the grammatical errors
Also, threw is not even close to being the same as through.
And yes, I sometimes unblock some of the folks who have very little to contribute to the topic just to get a laugh at what they post . . . especially the grammatical errors
Not always reliable . . .
Do you take Humana? Yes, we do . . . is not the same as "Do you take Humana HMO?
Many of the folks who answer the phone have no clue if the Humana plan they "take" is PPO or HMO and have no idea about the difference.
I can say the same for some agents who think HMO plans have identical networks to PPO plans.
Have a prospect who told me they were not interested in the Medigap carrier I suggested because none of their doctors "take" that plan.
Do they participate in Medicare?
Yes, but they won't take that carrier . . .
Have a nice day!
- Thread starter
- #20
newbie2001
Super Genius
- 202
Had a doc office tell me they don't take Humana PPO. I said you don't take out of network plans? They said no.
I asked to be transferred. Oh yeah we do I thought you meant Medicaid…
Like damn
