Obamacare Rates Jump 51%

[taterpeeler]

good story sman....... clients as a majority don't see or deal with all the screw ups we as agents go through......but they do on a regular basis deal with their doctor and the docs - which by the way supported ACA passage... don't give me the fact it was the AMA and a percentage of doc's are not members of the group, I could care less... they for the most part remained somewhat quiet and Obama trotted up there guys in white coats.... They need to get over it and be forced into playing ball.... yes, me a right winger is demanding laws to get them in line

 

[scagnt83]

But now there's a new question doctors offices are asking.

Doctors office - Is your plan on-exchange?

Patient - Yes

Doctors office - I'm sorry, we don't accept on-exchange plans


....................................



I realize that's a long story, but it's just more of the crap people are having to deal with. And this wasn't the last time this happened to a client of mine. So now not only are doctors going in and out of networks as they've always done, they are adding a new wrinkle and rejecting some who have on-exchange plans.

I thought that the on-exchange plans had the same or mostly the same networks as the off-exchange plans?

If a doctor is in a network, it is my understanding that they must accept ALL policies within that network, regardless of exchange status. If they dont they are in violation of their network contract with the carrier and could be dropped from the network if reported to the carrier....

Am I wrong?

 

[cadylou]

I thought that the on-exchange plans had the same or mostly the same networks as the off-exchange plans?

If a doctor is in a network, it is my understanding that they must accept ALL policies within that network, regardless of exchange status. If they dont they are in violation of their network contract with the carrier and could be dropped from the network if reported to the carrier....

Am I wrong?

Yes - you are wrong. Networks on the Federal exchange were narrower than networks off exchange in my markets.

 

[unic.consulting]

I thought that the on-exchange plans had the same or mostly the same networks as the off-exchange plans?

If a doctor is in a network, it is my understanding that they must accept ALL policies within that network, regardless of exchange status. If they dont they are in violation of their network contract with the carrier and could be dropped from the network if reported to the carrier....

Am I wrong?

You are right and wrong. If they are in network, they are in violation of their contract, but as Cadylou said, some on-exchange networks are smaller. But the doctor can't just say they don't accept on-exchange plans unless they've worked that out with the insurance company.

 

[scagnt83]

Yes - you are wrong. Networks on the Federal exchange were narrower than networks off exchange in my markets.

I was asking more about the plan being in the network issue.

I realize the exchange plan networks vary by region... however I didnt think there was significant differences in most areas.

Either way, as I understand it, if a doctor accepts a network, they cannot deny services to a plan based on the exchange status. They can dictate their network... but they cant dictate which plans within that network they accept. If they are part of a network and deny services to a plan within that network, they are in violation of their contract with the carrier.

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But the doctor can't just say they don't accept on-exchange plans unless they've worked that out with the insurance company.

Is that even possible to work that out and exclude certain types of policies that are within a network?

 

[GreenSky]

They need to get over it and be forced into playing ball.... yes, me a right winger is demanding laws to get them in line

Yes, and we need laws to force insurance agents to work for 1% of the non-subsidized commission. I guess you'll work for free and so should doctors. Oh yeah. If your client doesn't like the plan you get a chargeback after 60 days.

Restaurants should feed people even it they won't get paid. Gasoline (and especially Avgas) should be sold and if you want your money back you have up to 60 days to get a refund but you can keep the fuel.

Good plan. Surprised more "conservatives" haven't recommended it.

Rick

 

[unic.consulting]

Is that even possible to work that out and exclude certain types of policies that are within a network?

Here the network names are different whether on or off exchange. It would be possible for a doctor to contract with the insurance company for the off exchange network only even if all of the other benefits are available. If the networks are not separate, then no, it is not possible.

 

[somarco]

don't give me the fact it was the AMA and a percentage of doc's are not members of the group, I could care less...

You overlook one thing.

Obama lied to the docs.

Obama lied to the hospitals.

Obama lied to the carriers.

Obama lied to the "stupid voters"

If they are in network, they are in violation of their contract,

But they can always say they are not taking any new patients right now.

 

[sman]

You overlook one thing.

Obama lied to the docs.

Obama lied to the hospitals.

Obama lied to the carriers.

Obama lied to the "stupid voters"



But they can always say they are not taking any new patients right now.

Winner, winner, chicken dinner!

 

[GreenSky]

You overlook one thing.

Obama lied to the docs.

Obama lied to the hospitals.

Obama lied to the carriers.

Obama lied to the "stupid voters"

That's 4 things. Are you trying to say something?

Rick