• I am being treated at the major health facility near where I live, and they accept my insurance.

    Asked by Bloodproblems on Thursday, January 23, 2020

    I am being treated at the major health facility near where I live, and they accept my insurance.

    I need to see a urologist about what could be kidney issues that may or may not be related to my MM. I called that office to get an appointment and they say that they do NOT take my insurance. Even though it's in the same facility, inside the same brick walls, but a different specialty. I tried to tell this girl that yes, you DO take my insurance and you've already collected a whole bunch. All she could say was no, we don't accept it.
    So, I have turned blue from holding my breath and called another part of the facility to get someone from billing to call me back. How hard can this be?

    5 Answers from the Community

    5 answers
    • po18guy's Avatar

      I have not encountered that, but really, it sounds like urology wants higher compensation. A little "integrated care" would be nice, huh? Would a referral from your hematologist/oncologist help?

      about 1 month ago
    • GregP_WN's Avatar

      I have actually run across the exact same thing. I told this woman that the facility has been taking my insurance for 11 years, same facility, same insurance......no sir, I'm sorry we don't accept that insurance. I just gave up and went to a lesser facility closer to home.

      about 1 month ago
    • JaneA's Avatar

      Many facilities now treat doctors and or their practices as subcontractors. I'm guessing that is what is going on.

      about 1 month ago
    • Bengal's Avatar

      Just one thing that universal health care would fix. My eye care center just dropped all of it's patients covered by a particular insurer. Just informed them they were no longer welcome, find somebody else. Up here there are not that many choices but it was either find another doctor or change your insurer. Seems strange though that this could happen within the same facility but apparently it does. And, as I 've said before, people who are dealing with serious illness (or any illness) DON'T need to be dealing with this crap. Sorry you have to.

      about 1 month ago
    • BuckeyeShelby's Avatar

      I'm the one who works for a medical TPA. We aren't insurance; we just administer claims. We work w/a LOT of different networks from the big guys, like Cigna, UHC, Aetna. In a lot of cases, the contract with the insurance company is with the physician, not with the facility. So one doctor could be in network, but the guy across the hall in not. Now, most of our plans have what is called an "ology" benefit. That means if you go to an in network ER, it doesn't matter if a dr in is in or out of network. Or if you are in surgery, your anesthesiologist doesn't need to be in network, since you can't generally choose that specialist.

      about 1 month ago

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