Where’s my doc

KQED in California has been following several of its audience members’ experiences with Obamacare. Today’s story is about finding providers taking insurance and the joys of online provider directories:

I’ve been following Sue Kearney of Oakland. After confirming her doctors would take the insurance, she enrolled in an Anthem Blue Cross subsidized PPO plan with Covered California last fall. Then she scheduled appointments…

But at her first appointment, she was told that the doctor did not accept any Covered California insurance. Ditto for the other doctors. Kearney set up a screen share with me, logged into her account and confirmed for me that doctors showed up as accepting her insurance, but the office said they didn’t when she called them.

That sounds about right.

When I was a young health insurance bureaucrat who did not know any better, I helped to maintain the provider directory.  Provider data quality is a constant struggle to get a response from the office manager and the receptionist.  If we contracted with a large group, the central office would have a decent idea as to what their CFO or CEO signed but only seven of the thirty four receptionists or office managers were aware of the newest configuration of networks.

There are numerous points for failure in the provider directory informaation chain.  The most common is the office manager to health plan link. 

Office managers will assume that they have always taken all Mayhew products, so they still take all Mayhew products including the very narrow network, so they tell members that they’re participating in Mayhew Narrow, but they aren’t.  Members are shocked when they get billed out of network.  Office managers may reflect the attitude of their doctor(s) who are Randian fanboys and assume that they don’t take any Exchange, but their CEO signed them up.  Office managers may not be aware that a particular product is geographically restricted, so the office that they work at on Monday, Wednesday and Friday takes the product, but the office that they work at on Tuesday and Thursday can’t take the product.  They may also have amazing tacit knowledge which minimizes problems until they retire or move to a different job and the new kid has no clue. 

And then they just forget to tell the insurance company about important things:

  • The office burned down.
  • The office is uninhabitable due to the meth lab next door exploding.
  • The provider died two years ago.
  • The doctor in question moved three time zones away.
  • The doctor in question is in Congress now and no longer practices.
  • The office has been bought out by an integrated payer-provider system that does not contract with other insurers.
  • The doctor surrendered his license because of a very public front page scandal.

Those are some of the things that providers have forgotten to tell my company.

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82 replies
  1. 1
    Corner Stone says:

    OT, but since no Open Thread for a bit:
    The poor should stop whining, says luxury CEO
    “We’ve got a country that the poverty level is wealth in 99 percent of the rest of the world,” he said. “So we’re talking about woe is me, woe is us, woe is this.” He added that “the guy that’s making, oh my God, he’s making $35,000 a year, why don’t we try that out in India or some countries we can’t even name. China, anyplace, the guy is wealthy.”

  2. 2
    Sophist says:

    @Corner Stone:

    I mean, it’s not like shit costs more here, right?

  3. 3
    Omnes Omnibus says:

    @Corner Stone: The link didn’t work.

  4. 4
    Nutella says:

    The story is ambiguous. “After confirming her doctors would take the insurance” — does that mean Anthem said the doctors were on their list and were wrong or out of date? Or does it mean she asked the doctors and they were wrong?

  5. 5
    pseudonymous in nc says:

    The most common is the office manager to health plan link.

    Perhaps this is a bit harsh, but my personal experience of health provider office managers suggests they are recruited from a pool of tinpot dictators and Kafka characters. Any healthcare reform that forced them to seek new work — say, handing out parking tickets — would be worth celebrating.

  6. 6
    raven says:

    I rarely comment on Richard’s post because they are packed with great information and I just absorb it. At at least acknowledge that before you try to derail him.

  7. 7
    David in NY says:

    As Richard indicates, my recent experience is that it’s too darn hard, even with private insurance, to figure out who’s in network and who isn’t. Just tried to get an x-ray in network and then PT. As to radiology, the Insurance co.’s website is totally incoherent, having two different, conflicting, lists of in-network providers. As to PT, they just don’t even have any information, and you have to call around and trust whoever you get on the phone. Total waste of valuable time.

  8. 8
    Corner Stone says:

    @raven: Yeah, I almost never do either. But go fuck yourself.

  9. 9
    raven says:

    @Corner Stone: Hahahahaha, numb nuts.

  10. 10
    Corner Stone says:

    @Omnes Omnibus: Sorry.
    raven has determined it’s derailing but he can go fuck himself.
    http://finance.yahoo.com/news/.....MAEajQtDMD

  11. 11
    raven says:

    @Corner Stone: Dumb fuck can’t even derail right! Check in with ramalama ding dong, he does it all day long.

  12. 12
    David in NY says:

    @Nutella: And my experience suggests that it could be either problem (Ins. Co. error or office error), or both!

  13. 13
    David in NY says:

    Everybody adjust your derailleurs, OK?

  14. 14
    MomSense says:

    Right now the people who are insured through the exchanges, like Covered CA, are a pretty small piece of the pie. As more people are covered through exchange policies, do you think some of these providers will start accepting exchange patients?

  15. 15
    Corner Stone says:

    @raven: meh. Richie is a big boy, getting shout outs by the LA Times. I think he’ll survive.

  16. 16
    MomSense says:

    @David in NY:

    I have some ancient campy ones in my garage that need some serious adjusting.

  17. 17
    jl says:

    To each denial, (churn churn churn)
    There is a reason (churn churn churn)
    A time for every excuse, under Heaven.

    In an earlier RM thread, I expressed concern that the local oligopolistic market structure and pricing schemes of providers, and the Byzantine relations with payers would collide with health care reform. I figure the latter needs to destroy the former through price transparency in order for reform to work well. But I might well be wrong.

    Also, I think this is a symptom of a system of price discrimination that has grown beyond any legitimate purpose other than sucking every once of consumer or provider surplus out of the system into the pockets of whoever is big enough and powerful enough to grab it. I suppose long ago, Kenneth Arrows diagnosis that price discrimination was a good way to provide an economically efficient level of care with fixed costs that were very high (sometimes too high to even cross the demand curve) and market power. But maybe it has become a giant fight over money, leading to excessive churn in insurer provider contracting. RM can correct me if I am clueless on this.

    As I also said in a previous thread I am an Uwe Reinchardt-ian when it comes to analysis of cost structure of U.S. health care. The rent… er, cost, is too damn high (for no good reason).

    I’ve heard reports of similar provider mixups with prominent hospitals, which seems less understandable.

    WA: Seattle Children’s Sues the OIC
    By Grace Guenther , October 8, 2013
    http://stateofreform.com/news/.....s-sues-oic

    I think this is the same hospital that admitted some patients under the impression that the hospital was in network, but then it was discovered that it was not. Right now the hospital is paying for the care, but news report I heard said that, after a decent interval, they would come after the patients for the money, if they could not get retroactively in network for the plans.

  18. 18
    raven says:

    @Corner Stone: I’m just foolin around, we’re ice bound and I’m watching footie!

  19. 19
    OzarkHillbilly says:

    Those are some of the things that providers have forgotten to tell my company.

    I’m not surprised Richard. The Doctors offices I go to (BJC affiliated) regularly have a problem communicating from one part of it to another. Ex: Copays. Does not matter if I pay the copay at the time of the appointment or not. I always get billed for it. I tried not paying it at the time of appointment, but after I paid it thru the mail? I continued to get billed for it.

    So now I just call them up and call them incompetent boobs and then send them a bill for bookkeeping services. I mean, if I have to do it for them, I might as well get paid for it. (doesn’t work, but I feel better)

  20. 20
    SuperHrefna says:

    This is exactly what has been driving me nuts since I got my new HIP plan – I’m ok with narrow networks, but there are no in-plan hospitals within 20 miles of me!! And I can’t find a primary care doctor. The insurance works fine for prescriptions and going to urgent care clinics ( and there’s a great urgent care chain near me, STAThealth which I’ve been using for all my medical needs since jam first) but I am really rattled by not having a primary care, or an allergist, or a hospital…

    Last time I called the insurer to try to find a primary care doc and a hospital the lady at the other end told me maybe I needed to change to another insurer which left me nonplussed. I’m still feeling too weak from flu to deal, but maybe I do need to change? I still can, can’t i?

  21. 21
    SuperHrefna says:

    This is exactly what has been driving me nuts since I got my new HIP plan – I’m ok with narrow networks, but there are no in-plan hospitals within 20 miles of me!! And I can’t find a primary care doctor. The insurance works fine for prescriptions and going to urgent care clinics ( and there’s a great urgent care chain near me, STAThealth which I’ve been using for all my medical needs since jam first) but I am really rattled by not having a primary care, or an allergist, or a hospital…

    Last time I called the insurer to try to find a primary care doc and a hospital the lady at the other end told me maybe I needed to change to another insurer which left me nonplussed. I’m still feeling too weak from flu to deal, but maybe I do need to change? I still can, can’t i?

  22. 22
    Violet says:

    Health insurance related: I was cleaning out my spam folder and saw an email from “Presidential Health Insurance” with the subject line “Obamacare 5 Minute Check: What’s Your Most Affordable Option?” That seems like a good sign to me. If Obamacare has made it into spam emails, that’s got to be a sign that getting health insurance through “Obamacare” is a thing people do.

  23. 23
    a hip hop artist from Idaho (fka Bella Q) says:

    @David in NY: Mine are not in tune due to the sudden heat wave here. 34F at the moment and Layla is laying at the top of the hill looking down the yard, without a blanket on. We’re all confused.

    Sorry to flaunt our sunny skies to raven and crew down south.

  24. 24
    Amir Khalid says:

    @raven:
    Wow. You follow Aussie Rules too?
    ETA: It’s not quite the Miracle of Istanbul, but Liverpool have come from behind twice in this match and now they’ve won on an injury-time penalty, 2-3.

  25. 25
    Cliff in NH says:

    My F’n Dental plan, 576 premium per year, max payout per year 1000

    What a ripoff, I’m dropping it and getting a refund.

    ps. 12 – (24 prior work) month waiting period for anything that would max out that 1000 a year max benefit.

    F BCBS

  26. 26
    MikeJ says:

    @raven: And Liverpool barely escape with a win. They shouldn’t have had that much trouble with Fulham.

  27. 27
    Violet says:

    Richard, your posts are so good. I always learn something. We’re involved in the stupid network thing at the moment, along with the high deductible issue. Putting off a routine ultrasound because it will all be out of pocket due to high deductible. It’s not urgent, so I feel comfortable with that. Plus, I have to call around and find out what imaging places are accepting the insurance. That’s not the same as it was last year, so I have to do the phone work. Ugh.

    @raven: Hey raven, how’s the snow and ice in your area? Sounds bad.

  28. 28
    Cliff in NH says:

    @OzarkHillbilly:

    small claims: unpaid bills

    – depends on their incompetence of course.

  29. 29
    Fred Fnord says:

    Don’t hold your breath re: price transparency. I have a flex-spending plan, which requires at the very least a ‘superbill’ which has prices and procedure codes and diagnosis codes on it. Two of my providers (what a coincidence, the hospital and the clinic who use the same billing company) do not send them by default, do not allow you to request them online, do not apparently even respond to USPS requests for them (or they have not given me the right address to do so), and make you call the billing company to get them. The billing company is not, let’s say, responsive. Am I the only person actually using a flex spending plan? Or are they willing to sabotage EVERYONE who does so, just so that they don’t have to give out their prices and the insurance discounts any more often than absolutely necessary?

  30. 30
    Amir Khalid says:

    @MikeJ:
    Remember, Fulham are the bottom-of-the-table team who almost, almost sneaked a win over Manchester United at the weekend.

  31. 31
    cat says:

    Why is selling a health insurance policy that advertises your insurance network includes Dr X but Dr X isn’t in really in your network or Dr X refuses to accept you as a patient not a crime? It feels like fraud to me.

  32. 32
    MikeJ says:

    @Amir Khalid:Almost doesn’t count, and frankly beating Man U this year ain’t the big deal it used to be.

    Still, I like Fulham. I tend to like the scrappy little teams who have grounds that aren’t giant arenas

  33. 33
    MikeJ says:

    @cat: Fraud requires intent.

  34. 34
    Kylroy says:

    @OzarkHillbilly: This is how providers have been billing insurance companies for decades – to wit, early and often. When my employer handled Tricare we had an entire department that did nothing but strip out duplicate claims. A friend who worked in the department told me that his workload would spike at the end of each year from providers “shoeboxing” – that is, sending in every claim they’d made that year AGAIN, regardless of whether it was paid or not.

  35. 35
    burnspbesq says:

    @Amir Khalid:

    Any team with Champions League ambitions should be embarrassed to struggle against Fulham, who are going down.

    Also worth noting: I’m not sure that the weather in the southeastern US qualifies as worse than the weather in most of England and Wales.

  36. 36
    burnspbesq says:

    Please note: KQED is in San Fancisco, not in California.

  37. 37
    JPL says:

    @MomSense: That seems logical and hopefully Richard addresses that.

    Richard, Congrats on the LATimes piece that mentioned you.

  38. 38
    superfly says:

    Richard, virtually all of your posts are just more evidence that the whole system needs to be blown up.

  39. 39
    Amir Khalid says:

    @MikeJ:
    True, but United have the same squad they had before Moyes showed up. Fulham arguably played above themselves both on Saturday and today. They got only one point from two matches, but it could so easily have been all six.
    ETA: And Liverpool showed tremendous character today to twice come back from behind, and win it at the death.

  40. 40
    Zoogz says:

    Ditto-ing Richard’s info above, with a personal, verifiable anecdote… after four little ones, my wife looked into sterilization. Instead of the hospital, her doctor told her that she’d have it done outpatient and at a clinic right next door to the hospital. Got the bill for it two months later, >$3000. We called the insurance company and asked why the heck it was so high… they responded that *the facility* that our covered doctor performed the procedure in was out of network, so we had to pay the premium out-of-network costs.

    By the way, why couldn’t we have it done at the in-network hospital? We were told that because it was a Catholic hospital, they refused to perform such procedures. Hence… much extra money paid out for a procedure that will greatly limit health insurance costs in the future (having a kid is ‘SPENSIVE now.)

    So, yeah, even if it’s the same doctor there’s no guarantee.

  41. 41
    SiubhanDuinne says:

    @raven:
    @JPL:

    You guys okay? Here in Duluth it seems to be raining ice. Not so much as a light bulb flicker, so at this point I’m not worried about power outages. But you couldn’t pay me to go out on the roads. I’m hunkered in until Friday, I expect.

    (On edit:apologies to everyone else for going O/T.)

  42. 42
    cat says:

    @MikeJ: So bureaucratic incompetence and willfully not insuring your data is correct is a shield for misdeeds? Seems wrong.

  43. 43
    Mnemosyne says:

    @burnspbesq:

    San Francisco is not in California? When did that happen?

  44. 44
    jl says:

    @Mnemosyne:

    ” San Francisco is not in California? When did that happen? ”

    I grew up mostly in California, and have lived in San Francisco.
    San Francisco is not, and is not in, California.

    Regardless of certain legal and geographical niceties.

  45. 45
    Amir Khalid says:

    @Mnemosyne:
    No, no, no. He’s talking about San Fancisco, which is a completely different city from the one you’re thinking of. Right, Burnsie?

  46. 46
    Cliff in NH says:

    @SuperHrefna:

    maybe I do need to change? I still can, can’t i?

    https://www.healthcare.gov/glossary/open-enrollment-period/
    The period of time during which individuals who are eligible to enroll in a Qualified Health Plan can enroll in a plan in the Marketplace. For coverage starting in 2014, the Open Enrollment Period is October 1, 2013–March 31, 2014. For coverage starting in 2015, the proposed Open Enrollment Period is November 15, 2014–January 15, 2015. Individuals may also qualify for Special Enrollment Periods outside of Open Enrollment if they experience certain events. (See Special Enrollment Period and Qualifying Life Event)

    You can apply for Medicaid or CHIP, at any time of the year.

    ———————————-

    the intra-month deadline is the 15’th, so if you can get the application done before the 15’th you can get coverage starting at the end of the month.

    look at silver plans as they have a cost share tax credit you can claim if your income fluctuates.

  47. 47
    boatboy_srq says:

    @Sophist: Indeed. FSM forbid that that $35K/yr person find safe, weatherproof accommodation for self and family for $250/mo (which rents a 1200sq ft 2BR in Bangalore), or keep commute costs below $15/mo, or anything. Geez.

  48. 48
    maximiliano furtive, formerly known as dr. bloor says:

    And of course, as is always the case with Richard’s charming anecdotes about doctors, it would be absolutely impossible for Mayhew Insurance to fuck up. I’m still on a number of online panel directories that I took myself off of years ago, and listed at addresses I haven’t practiced at in years. And I’m my own CEO, I write my own letters to the companies telling them I’m out.

    There’s no reason for them to tell their potential customers that huge chunks of their directories are dead listings.

    If you want to know if your doctor will take your insurance and hold you responsible for nothing beyond the contracted deductibles/copays, ask the doctor’s office if s/he is on your panel and accepts contract rates. Don’t assume anything, and don’t get your information from the insurance company.

  49. 49
    Seanly says:

    Every f’ing thing with health insurance just points to that we should have single f’ing payer. I have no qualms about soc1alism.

  50. 50
    Mnemosyne says:

    @maximiliano furtive, formerly known as dr. bloor:

    That’s kind of the problem, though — sometimes even the doctor’s office doesn’t know. I’ve had a similar experience as OzarkHillbilly has had with one of my doctors — the front desk staff tell me there’s no copay, and then the back office staff sends me to collections because I didn’t pay the copay. I basically force them to take the money at every appointment even though they don’t want to because I KNOW their back office is going to send me a bill afterwards.

  51. 51
    Cliff in NH says:

    @Seanly:

    see my dental plan: it’s a cash sink, it’s impossible to get benefits equal to the payin, the math is designed to destroy the buyer of dental on the individual market.

    ps: its still a good deal if you have kids, it’s individuals over 19 that are screwed.

  52. 52
    maximiliano furtive, formerly known as dr. bloor says:

    @Kylroy:

    When my employer handled Tricare we had an entire department that did nothing but strip out duplicate claims. A friend who worked in the department told me that his workload would spike at the end of each year from providers “shoeboxing” – that is, sending in every claim they’d made that year AGAIN, regardless of whether it was paid or not.

    When insurance companies routinely misprocess, lose or otherwise fail to pay 3-10% of my clean claims and fails to pay an even higher percentage within the 30 day standard, you’re goddamn right I’m going to file everything in duplicate, whether it’s been paid or not. An insurance company’s acceptable margin for error on mass processing of claims is a measurable portion of my income.

  53. 53
    Corner Stone says:

    @Sophist: I think, if you listen to him a little bit, that he’s saying the shit his company sells is for those with ultra disposable income.
    And every other worker should watch out because they (the 1%) desire nothing more than moving the cost jurisdiction to places where $35K really is a great living.
    What this clownish buffoon does not seem to get, or doesn’t care to acknowledge, is that wage pressure is absolutely eating up these secondary and tertiary marketplaces.

  54. 54
    JPL says:

    @SiubhanDuinne: I’m just iced in. The city of Roswell sent out an alert mentioning the possibility of seven to nine inches of snow tonight. Good times!

  55. 55
    Ruckus says:

    @OzarkHillbilly:
    Once told an ER insurance/admission lady to send the bill to president bush. When asked why I replied that he was the one that told me my health care is provided by the local ER. She didn’t think it was that funny. I told her I wasn’t making a joke.

  56. 56
    maximiliano furtive, formerly known as dr. bloor says:

    @Mnemosyne: If the back office is sending you to collections–as in, an external collection agency–before sending you a statement for your contracted copay, they’re almost certainly breaking state law. If you mean to say they’re just sending you a bill after they said there was no charge, I don’t really see a huge headache here. Don’t pay at the time of the visit, and let them catch up with you.

    That aside, copay coordination and determining whether a doc is on a particular panel are two separate issues. The office manager will almost always take your insurance information and determine in real time whether the doc is on your plan.

  57. 57
    SuperHrefna says:

    @Cliff in NH: thanks! So I have until March 14th to get my act together.

  58. 58
    boatboy_srq says:

    @cat: Who would you charge? The provider, who’s going off what the office staff tell them? The office staff (and RM shredded that pretty effectively)? The MDs, whose only awareness of insurance is their malpractice coverage?

  59. 59
    boatboy_srq says:

    @jl: San Francisco is to California as Atlanta pretends to be to Georgia.

    With that said, though, KQED is a pretty decent outlet. For NPR…

  60. 60
    jl says:

    @maximiliano furtive, formerly known as dr. bloor: there are problems and issues on both sides.

    One problem providers have, that RM does not mention, is that they have to deal with more than one payer. I don’t know if things are as bad in other parts of the country, but in large urban areas of CA, docs may have to deal with half a dozen or more payers, each with their own very serious and important (maybe, maybe not) protocols and forms and whatnot.

    Sadly the eponymous Mayhew Insurance Company is not the only game in town.

  61. 61
    Ruckus says:

    @maximiliano furtive, formerly known as dr. bloor:
    In the past this has been my experience as well. Dr. want to get paid as you have pointed out here. And for sure they should if they provided a service.
    But what happens to a lot of people I believe is that the office will send your info to collections, properly or not and that leaves you trying to fight getting rid of a bad or lowered credit rating that you don’t deserve. And that can be debilitating to one’s life. The entire system has so many holes that can trap even the most cautious person financially. From bad info up front to having screwed up credit and all the stops discussed above. There has to be a better way. And of course there is but some will get screwed no matter how we get there. And most of the those screwed in a change to single payer will be those with money or making money. That’s the major reason I see single payer not happening in my lifetime.

  62. 62
    jl says:

    @boatboy_srq: I do agree that I’ve seen more Georgia in Atlanta than California in San Francisco, and from liberal Atlantans of all types. Except the godless commies from the CDC, who are not from Atlanta apparently, but from the CDC.

    EDit: meaning I am center right in SF, moderate liberal in NorCal, liberal in CA, and flaming out of my cotton picking commie weirdo mind in Atlanta, even if I halfway defend or even try to explain anything about the quaint ways and interesting beliefs of the left coast mini-metropolis.

  63. 63
    Mnemosyne says:

    @maximiliano furtive, formerly known as dr. bloor:

    If you mean to say they’re just sending you a bill after they said there was no charge, I don’t really see a huge headache here. Don’t pay at the time of the visit, and let them catch up with you.

    Well, except for the additional fee they add for not paying the copay at the time of the service. I really don’t see why I should have to pay an extra $5 for them to mail me a bill for a fee that the front desk staff told me I didn’t have to pay in the first place.

  64. 64
    Cliff in NH says:

    @SuperHrefna:

    the sooner you start the better, I can’t recall if it’s the date you start or the date you succeed that counts.

    the income verification and identity verification can take time if it’s your first time thru..

  65. 65
    Cliff in NH says:

    oh, but if you are in a hurry to beat the deadline you can decline the credits, pay the full premium and sort out the credits once you are signed up.

    if you have weird problems, start over with a new email address, thats what got me thru.

    ——————————-

    Append a plus ("+") sign and any combination of words or numbers after your email address. For example, if your name was hikingfan@gmail.com, you could send mail to hikingfan+friends@gmail.com or hikingfan+mailinglists@gmail.com.
    Insert one or several dots (".") anywhere in your email address. Gmail doesn't recognize periods as characters in addresses -- we just ignore them. For example, you could tell people your address was hikingfan@gmail.com, hiking.fan@gmail.com or hi.kin.g.fan@gmail.com. (We understand that there has been some confusion about this in the past, but to settle it once and for all, you can indeed receive mail at all the variations with dots.)

  66. 66
    rikyrah says:

    @cat:

    Why is selling a health insurance policy that advertises your insurance network includes Dr X but Dr X isn’t in really in your network or Dr X refuses to accept you as a patient not a crime? It feels like fraud to me.

    Not just you.

  67. 67
    Cliff in NH says:

    @SuperHrefna:

    So I have until March 14th to get my act together.

    I Highly recommend at least opening a account on heathcare.gov, beginning the process in the next 3 days, do as much as you can, as soon as you can.

    if you complete(start?) by the 15’th your coverage will start at the end of the month, ditto march 15th for April 1 start

  68. 68
    SuperHrefna says:

    @Cliff in NH: I already have an Obamacare plan, it just doesn’t cover any hospitals in my area! So the idea is getting a different one whose narrow network would at least cover something local to me.

  69. 69

    I have regular Blue Cross/Blue Shield of TN — no Obamacare here because FREEDOM! — but a couple months ago I needed a new doctor and after calling about 10 doctors listed on the BCBS provider directory as being in network (none of whom said they were taking new patients anymore) I finally just called Vanderbilt Medical Center and asked if they had ANY internists taking new patients. Nope. Not a one.

    I finally found one doctor at grrr grr Centennial Medical Center (the dreaded Frist family, which I was trying to avoid!). He looks like he just got out of medical school last week.

    Fortunately I just need someone to go to as a backup and for the occasional cold or flu but damn that’s frustrating. Everyone is a fucking specialist now. No one is just a regular old doctor, and those that are won’t take new patients. Can’t blame that on Obamacare.

  70. 70
    Cliff in NH says:

    @SuperHrefna:

    in that case you should be ok, just get started in the next few days, I think you have 30 days from when you get your plan packet to get a full refund of premiums you didn’t really want to pay, that’s what I am going to try with my dental plan(got the dental packet 2-10-14 for coverage starting 1-1-14), I haven’t yet gotten my plan packet for the heath care even tho I signed up ages ago. I just got my card 2 days ago for coverage that started 1-1-14, no packet for that yet.

  71. 71
    Emerald says:

    This is the exact reason I chose Kaiser. While I was trying to decide which plan to choose I learned that Blue Shield and others were only going to use 50% of their networks for Covered California, but Kaiser was using its full network.

    My doctors showed up in the search tool for being in Blue Shield, but I was really concerned that when I actually got to the office I’d find out that most of them actually weren’t in the network.

    With Kaiser I knew I’d be safe. And I am. I’ve had a doctor’s appt., lab tests, and a mammogram. So far the whole expense to me has been $30 (not including my $95/mo. premium).

    This after more than 12 years uninsured.

    I’m pretty happy.

  72. 72
    Cliff in NH says:

    oh, and note that its more than a month and I have not yet gotten a bill in the mail, what is wrong with these morons?

    I don’t even know what I’m paying for if they did send a bill as I have not yet received a plan packet describing what I am paying for F BCBS. WTF.

  73. 73
    TrishB says:

    This is going back to, oh, let’s call it 1997. So a rather large and prestigious NE Ohio based clinic has a rather standard IT service help desk support contract. Someone from marketing calls in requesting support with MS Excel because they just know that as long as they have the list of providers in csv format, it will be flat out simple to create a provider directory that will look just perfect when printed as a booklet, location, specialty headers, cross referenced, etc. A few hours later (no call was to last more than 30 minutes) the very unhappy person gets sent my way, because of course while we can’t help them with this in Excel, Access will make it so, so simple, graphics and all. Except no one at the marketing office has ever used Access and I’m really not supposed to conduct on the phone training, and even if I could, I might try to shoot myself before trying to teach even the most remedial intro to databases that way. So, yeah I ended up creating a crap db and reports at 2am that could output one semi half-decent looking report that would print well. Honestly, if anyone is relying on a helpdesk grunt to create a provider directory, nope, they ain’t to be trusted.

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    Roger Moore says:

    @Zoogz:

    By the way, why couldn’t we have it done at the in-network hospital? We were told that because it was a Catholic hospital, they refused to perform such procedures.

    More evidence, as if it were needed, that churches who refuse to let the hospitals they own carry out legal procedures should be forced to divest, at a loss if necessary.

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    Roger Moore says:

    @Southern Beale:

    Can’t blame that on Obamacare.

    Sure you can. As the Republicans routinely demonstrate, it’s perfectly possible to blame anything on Obamacare.

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    Nutella says:

    @Roger Moore:

    churches who refuse to let the hospitals they own carry out legal procedures

    are profoundly immoral actors.

  77. 77
    Ruckus says:

    @Nutella:

    are profoundly immoral actors.

    Which has been proven many, many times over the eons.

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    kindness says:

    I work for Kaiser but I also like the system they have for care. If you have a doctor who isn’t Kaiser that you want to keep then don’t go with Kaiser. You won’t see that doctor. But my doctor is great. Kaiser isn’t the cheapest in California though. From what I hear they’re about the middle.

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    Richard Mayhew says:

    @Corner Stone: Thanks, and not a problem as I can count on Balloon Juice comment threads to go where they will, not where I wish. And BTW — LA Times mentioned me? Where?

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    Richard Mayhew says:

    @cat: Because there is small print that says “call the provider to confirm, this is only advisory and providers can come in and out of network at any time…”

  81. 81
    Richard Mayhew says:

    @maximiliano furtive, formerly known as dr. bloor: Oh no, we fuck up plenty of other things (don’t ask me about the difference between embedded and aggregated out of pockets on EOBs), but the directory is one area where most of the fault is not in my building.

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