Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Nobody has purchased through the exchange yet. If what OP says is true then medical practices will eliminate all those covered by the "exchange" companies including employee plans and private individual policies. That makes no sense at all. Suddenlly dumping BCBS patients from all walks of life because ACA?
It's not venom, it's you telling tales ("have you heard???") with no details. What the name of the big medical practice? Maybe someone knows more than you do about it and can jump in. I'm saying it's not going to happen though since I can just as easily buy outside the exchange as inside.
I referred to a specific large medical practice. Not ALL medical practices. No one mentioned BCBS either. Where did I mention anything about "walks of life". No tall tales here. I simply relayed some information given to the Assembly Health and Senior Services Committee by this practice.
This is a fiscal decision by this practice. Just like medicaid reimbursements, they want to see what type of reimbursements are given under coverage within the exchange. They don't have that information yet so they are waiting to see how bad it will be. It's just economics.
...This is a fiscal decision by this practice. Just like medicaid reimbursements, they want to see what type of reimbursements are given under coverage within the exchange. They don't have that information yet so they are waiting to see how bad it will be. It's just economics.
Fair enough. The doctors aren't making a political statement - they're making an economic statement. If reimbursements are Medicare rates or higher (depending on the nature of the practice - some specialties do ok under Medicare rates - others don't) - they'll probably accept the insurance. If they're like Medicaid - they won't. Robyn
Not all doctors have signed up with all of the various insurance companies to be in network. This is not new but has been exacerbated by the ACA. The info been out in Calif for awhile. The best Gold plan had over 8000 doctors in network and the worse bronze had over 2000. Some of the insurance companies are new or subsidiaries operating only in the exchange.
Not all doctors have signed up with all of the various insurance companies to be in network. This is not new but has been exacerbated by the ACA. The info been out in Calif for awhile. The best Gold plan had over 8000 doctors in network and the worse bronze had over 2000. Some of the insurance companies are new or subsidiaries operating only in the exchange.
Kind of sounds like many property insurance companies in Florida - poorly capitalized companies picking on the bones of people who can't afford to pay decent premiums to buy decent coverage from decent companies. Robyn
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....
That makes sense to me. I know, for instance that many of those insurances that now offer healthcare plans will be joining the exchanges in many states.
For instance, the State of Florida Blue Cross/Blue Shield that some of my family members and friends have had for years, and which is accepted in most of the healthcare facilities where we have lived, will also be offering plans on the Health Care exchanges. As I see it, it's the insurance policy that counts, not where it came from.
Unfortunately, there's no provision in Obamacare that allows purchase of insurance plans across state lines, so any number of states are stuck with just a couple insurance plans on their exchanges that aren't the best choices.
Kind of sounds like many property insurance companies in Florida - poorly capitalized companies picking on the bones of people who can't afford to pay decent premiums to buy decent coverage from decent companies. Robyn
If you were a doctor would you want a patient behind on their mortgage and credit card debt to have to personally pay for 4O percent of their bill?
That makes sense to me. I know, for instance that many of those insurances that now offer healthcare plans will be joining the exchanges in many states.
For instance, the State of Florida Blue Cross/Blue Shield that some of my family members and friends have had for years, and which is accepted in most of the healthcare facilities where we have lived, will also be offering plans on the Health Care exchanges. As I see it, it's the insurance policy that counts, not where it came from.
Unfortunately, there's no provision in Obamacare that allows purchase of insurance plans across state lines, so any number of states are stuck with just a couple insurance plans on their exchanges that aren't the best choices.
Most of Mississippi has only one plan with no expanded Medicaid. Rate comparisons today are all over the place when states are compared with each other.
I am guessing they will stick with insurance plans that don't participate in the exchange. Medicare is a huge portion of the practice so those patients will continue to be accepted.
You guessing wrong then. Doctors accept insurance based on how much they get reimbursed for there services and how easy it is to get paid for there services. For example if they charge $1,000 for a medical procedure retail (the uninsured), and ABC insurance company is willing pay them $400, BCD is willing to pay $500 and Medicare is paying $350, but BCD is a nightmare to get them to pay claims, a doctors practice might just accept ABC and Medicare, but avoid BCD because the administrative fees are too high to get BCD to pay there claims.
My wife is a therapist and currently accepts every insurance company in existence in New Jersey except medicare/medicaid. Some insurance companies pay her more for her services, some less and some are a real hassle to get them to pay there claims. If she decides that she doesn't want to deal with a particular insurance company with proper notice (three months I believe) she can drop the company from insurance she accepts. She needed to accept all insurances to get patients to keep her appointment schedule full with patients, but now that she has a full schedule, she can drop insurance companies that pay poorly or are a pain to collect from.
Doctors would really just prefer everyone pays cash, full price there there services, but unless they are a specialist in really high demand, in a wealthy area, they would go out of business very quickly, since very few people can afford to pay full price for medical procedures. So they HAVE to accept insurance to stay in business. Which insurance and how many all really depends on where the practice is. Doctors in wealthy areas can get by with just a few insurance companies that reimburse at better rates, doctors in poor areas pretty much have to accept every insurance company including medicare.
In short medical practices will accept insurance companies based on there financial need to pay the bills. regardless of where the policy was purchased from.
Last edited by TechGromit; 10-01-2013 at 06:38 PM..
That makes sense to me. I know, for instance that many of those insurances that now offer healthcare plans will be joining the exchanges in many states.
For instance, the State of Florida Blue Cross/Blue Shield that some of my family members and friends have had for years, and which is accepted in most of the healthcare facilities where we have lived, will also be offering plans on the Health Care exchanges. As I see it, it's the insurance policy that counts, not where it came from.
Unfortunately, there's no provision in Obamacare that allows purchase of insurance plans across state lines, so any number of states are stuck with just a couple insurance plans on their exchanges that aren't the best choices.
Not only are policies not available across state lines - they're not available across county lines in Florida. The policy that may be available in Broward County may not be available in Seminole County. Everyone in Florida will have to check depending on the county where he/she lives. Robyn
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
Your well to do hospitals aren't accepting many uninsured patients. My wife works in one of them. So let's criticize a hospital that at least is attempting to serve that community.
And if you think that Medicare and Medicaid fraud is confined to just "inner city" hospitals, you are viewing the healthcare world with rose colored glasses. I worked in a LARGE hospital system that some years ago settled with the federal government for hundreds of millions of dollars of coding fraud. And every day I went into that medical records department and was routinely told to ignore part of the settlement agreement regarding how records were to be kept and stored.
That's what gets to me. So many people blindly believe that quality of healthcare is not an issue in our wonderful system. Read Dr. Marty Makary's book, "Unaccountable" to get an idea of just how corrupt the system really is. And since healthcare lobbyists have spent more money in Washington over the past five years than has the combined totals of the oil/gas and defense contractors lobbyists, I rest my case. The opposition to reforming healthcare is always from those who benefit most.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Of course it is!
:
.
. Robyn
