Doctors Not Taking Exchange Plans?

Yagents

Guru
5000 Post Club
12,093
Arizona
And now we know why they are not accepting patients with exchange plans.

New ACA Insurance Causes Headaches In Some Doctors' Offices - Kaiser Health News
That doesn’t sound like many new customers, but it’s presented a major challenge: verifying that these patients have insurance. Each exchange patient has required the practice to spend an hour or more on the phone with the insurance company. “We’ve been on hold for an hour, an hour and 20, an hour and 45, been disconnected, have to call back again and repeat the process,” she explains. Those sorts of hold times add up fast.
In the past, offices have been able to make sure patients are insured quickly, by using an online verification system. But for exchange patients, practices also have to call the insurerto make sure the patient has paid his premium. If he hasn’t, the insurance company can refuse to pay the doctor for the visit, or come back later and recoup a payment it made.
That’s because of a provision of the law that gives exchange patients who neglect to pay their premium a “grace period” of up to 90 days. During the first 30 days, insurers have to pay any claims incurred by the patient. But for the next 60 days, nothing is guaranteed. If the patient visits the doctor, the insurer can “pend” the claim – that is, wait to pay the doctor until the patient pays his premium. At the end of the 90-day grace period, if the patient has not paid the premium, the insurer can cancel the coverage and refuse to pay the pended claims, or recoup the payments it’s already made. And that puts the doctor’s office at risk.
So Lawless is checking first with the insurer to make sure that everything is in order before proceeding with the visit. If the premium has not been paid, Lawless gives the patient the option of rescheduling the appointment or paying in cash and then applying to his insurer for the payment.
 
That can't be the "why", it's a story of a doctor that DOES accept exchange plans.

They're having a hassle doing it, but they are taking it.

The rest of the doctors that "don't accept exchange plans", quite literally, don't accept them at all. Never did, never tried, never experienced these issues, never even got in the network.

That's the real issue, not the (hopefully) temporary issue of delayed ID cards. This is a hiccough for those accepting it, not a reason for tens of thousands of doctors to cease accepting plans before they were ever in effect.
 
I just had a client finally get her cards for 1-1-14 effective date, ridiculous!

I received mine on Friday.

1/1 effective. Signed up in October...

It's certainly creating a hassle for everyone in the industry, from providers to brokers to those trying to make use of it. Paying out of pocket and submitting for reimbursement is not a solution.
 
I received mine on Friday.

1/1 effective. Signed up in October...

It's certainly creating a hassle for everyone in the industry, from providers to brokers to those trying to make use of it. Paying out of pocket and submitting for reimbursement is not a solution.

Good luck with that. They have enough trouble collecting co-pays and deductibles.
 
Back
Top