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Old 10-01-2013, 12:01 PM
 
Location: Denver, CO
2,746 posts, read 1,094,477 times
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Default Hospital looking into paying for ACA policies

A local Dallas hospital, Parkland (where Kennedy was taken when he was shot), is looking into paying for the ACA insurance for people who would sign up through their hospital. Since that hospital sees a LOT of uninsured patients through their ER, it would make sense for them to know that they would collect something from the uninsured. They have a team studying to see if it would be cost efficient.

Incidentally, they have no assurance that purchasing coverage for someone would assure them that that individual would then use their facilities.

Bottom line, there are as many positives coming out of ACA as there are negatives.
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Old 10-01-2013, 12:32 PM
 
126 posts, read 319,524 times
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IT is not political. IT is low reimbursement and ALOT of RED TAPE. Doctors offices are closing because of the RED TAPE and updating computers system. However iI am just advising pople to review the ins policy before accepting it. You need the info on DOCTORS HOSPITALS AND SPECILIST. Or you might regert that you signed up with that insurance company
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Old 10-01-2013, 12:56 PM
 
Location: West Orange, NJ
11,673 posts, read 8,281,607 times
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Quote:
Originally Posted by ebbe View Post
Does anyone else know of doctors who are declining to accept patients who get healthcare under the ACA? I'm seeing this and wonder if others are yet.
how would a doctor know if you got your health insurance from ehealthinsurance.com or by logging into the state exchange? all the doctor will see is Blue Cross Blue Shield, no matter where you found it....
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Old 10-01-2013, 12:59 PM
 
Location: West Orange, NJ
11,673 posts, read 8,281,607 times
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Quote:
Originally Posted by High_Plains_Retired View Post
Based on my discussions with my doctor on the generalities of the ACA, I don't think he will accept the program's patients. I know he does not accept Medicaid patients now.
again, how will this doctor know someone obtained health insurance via the ACA exchanges?
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Old 10-01-2013, 01:12 PM
 
1,829 posts, read 1,161,262 times
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Quote:
Originally Posted by ebbe View Post
I am guessing they will stick with insurance plans that don't participate in the exchange.
In my state the insurance company that insures the largest employer and almost all state workers is one of the compnaies selling on the exchange. Are you telling me your Doctor will give up that business just because they now sell on the exchange? That's total bull. My employee's health cards do not have our name on it because we are too small (still over 50) so the dcotor can't even use that line of nonsense to make the claim of not accepting exchange purchased insurance.

The doctor has agreed to accept certain insurance plans such as ABC Company's PPO plan. If the exchange insurance is a PPO from ABC Compnay, guess what?, your doctor WILL be accepting it.

I think your doctor is just playing you the fool because they think your that guliable to beleive what they say without checking the facts yourself. Look at it this way, what would you say if the doctor said they will not accept a Visa card applied for from some direct marketing application mailed to the person's home but only from those applied for on an application the person picked up at a bank branch. You would be laughing your pants off at that doctor because you know how stupid that explaination is, So who is the fool, the doctor who says it, or the idiot who belives it?
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Old 10-01-2013, 01:17 PM
 
1,829 posts, read 1,161,262 times
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Quote:
Originally Posted by Hedgehog_Mom View Post
I think it will be obvious who purchased through the exchange and who has coverage from an employer, because insurance cards generally say who the employer is.
Not all employers have their names on the insurance cards!
Not all medical insurance is employer provided (there are people who were lucky to get it privately)!
If a doctor has signed a contract to accept a certain type of plan by a specific insurance company, they WILL also accept those who bought on the exchange. Thgey only know what insurance company and type of plan they accept, not where the person bought it.
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Old 10-01-2013, 01:42 PM
 
20,802 posts, read 30,296,490 times
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Quote:
Originally Posted by GreggT View Post
As I have as well as others, NO PRACTICE can find out where your insurance was purchased from. If you have BC/BS that's all they care about, it's about the money and will they pay the charges.



Most doctors I know would go out of business if it was not for Medicare as it makes up the bulk of their practice. In refusing new Medicare patients the main reason is due to an already overloaded practice. Our GP already has 1,100 families that he and his staff sees, they are not accepting any new Medicare patients and in fact are not accepting anybody new.
Actually, each plan has a group number and that number is tied to the company that purchased the policy. I am guessing that there will be a "group" number for private plans that is probably unique to the level of plan you buy from the exchange.

A large practice that isn't taking any "ACA insurance" either is clueless to what the ACA really is or is just plain stupid and will lose a significant portion of their patients.
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Old 10-01-2013, 01:47 PM
 
Location: Ponte Vedra Beach FL
10,812 posts, read 7,285,429 times
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Quote:
Originally Posted by Rabrrita View Post
...The doctor has agreed to accept certain insurance plans such as ABC Company's PPO plan. If the exchange insurance is a PPO from ABC Compnay, guess what?, your doctor WILL be accepting it...
OTOH - ABC company may have more than one PPO plan - even more than one PPO exchange plan (like one plan for "Bronze" policies - another for "Platinum" - etc.). With different preferred providers on different plans. Also - ABC company may only be offering HMO policies on the exchanges - not PPO policies (although it might be offering PPO policies outside the exchanges). Or more than one flavor of HMO policy - each with different networks.

The important thing anyone dealing with health insurance has to remember - no matter where he or she is buying insurance - is that if you're dealing with a PPO or an HMO - the provider's contract (if he - she - it has one) is with the insurance company - not with the insured. Unless the provider has a contract with a PPO or HMO - your insurance won't cover you - or will only cover you partially (depending on the terms of your insurance policy).

I get a fair amount of medical care at Mayo Clinic JAX - and this is what its website says in part. The same would apply to most other providers:

Mayo Clinic has contracts with many national insurance carriers, third-party administrators and employers. If you are a member of a preferred provider organization (PPO) or health maintenance organization (HMO), please contact your health plan before scheduling a Mayo appointment to determine your plan's participation with Mayo Clinic and the terms of your contract. Please note that Mayo participates with a limited number of HMOs; all require medical director referral before appointments can be scheduled.

Claims will be filed to your commercial PPO plan. If Mayo is not part of your PPO network, your out-of-pocket expenses will increase. (PPOs reimburse at a lower rate when services are received outside the PPO network.)

Copayments will be collected during registration. You are responsible for the initial deductible, coinsurance, copayments and any charges for noncovered services...

It's your responsibility to be aware of the terms of your health plan.


Robyn
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Old 10-01-2013, 02:08 PM
 
Location: West Orange, NJ
11,673 posts, read 8,281,607 times
Reputation: 3141
Quote:
Originally Posted by ebbe View Post
Yes, I did. They will know which companies are not participating in the exchange. They can choose to stick with those companies.
that makes no sense at all. so they are going to stop accepting all patients who's insurance companies chose to participate in a competitive marketplace?

man - that sucks. they're going to be kicking out a lot of existing patients then.

unless this is all just b.s., which it is....
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Old 10-01-2013, 02:12 PM
 
Location: Ponte Vedra Beach FL
10,812 posts, read 7,285,429 times
Reputation: 3811
Quote:
Originally Posted by Wardendresden View Post
A local Dallas hospital, Parkland (where Kennedy was taken when he was shot), is looking into paying for the ACA insurance for people who would sign up through their hospital. Since that hospital sees a LOT of uninsured patients through their ER, it would make sense for them to know that they would collect something from the uninsured. They have a team studying to see if it would be cost efficient.

Incidentally, they have no assurance that purchasing coverage for someone would assure them that that individual would then use their facilities.

Bottom line, there are as many positives coming out of ACA as there are negatives.
A hospital that has settled government allegations of Medicare and Medicaid fraud wants to buy medical insurance for its patients :

http://www.dallasnews.com/investigat...estigation.ece

Tell me how this is a positive - a good thing. Perhaps I'm missing something .

BTW - the reviews of this hospital are - overall - not that great (it seems to be your typical inner city county hospital). Perhaps it should buy life insurance on its patients too . Robyn
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