I’m in PA and have Independence Blue Cross Personal Choice PPO.
I was referred to a provider by a family member and called to make an appointment. I completed a screening questionnaire and sent my insurance cards and then didn’t hear anything.
I had to call them several times, the story is that he’s negotiating with the payer and said I could call BCBS. I went on the Independence website to verify my eligibility on the Independence website, called them again and offered to pay out of pocket until they hear from BCBS just so I could see the doctor and she said no, because it would look bad for the doctor to see a BCBS patient as direct pay and it could mess up their negotiations. I called Independence today and the rep said the provider accepts my plan and that there’s no change to his account that would indicate that he doesn’t. She said to call him again and if they won’t take me, to call back because it’s “weird”
At this point I’m looking for another doctor, I wanted to see him specifically because he’s a specialist but it’s obviously not going anywhere. But my question is this, I’ve never heard of a provider refusing to treat an in-network patient because they’re renegotiating their fee schedule, and refusing to let them pay out of pocket because it “looks bad” to the payer. Is this common? Is it legal? Is it something I should report to BCBS that he’s turning away patients to get better negotiating terms?
TL;DR Doctor won’t take my insurance even though he’s in-network and won’t let me pay out of pocket because it will mess up his negotiations with BCBS.
submitted by /u/Icy_Deal_5669
[link] [comments]I’m in PA and have Independence Blue Cross Personal Choice PPO. I was referred to a provider by a family member and called to make an appointment. I completed a screening questionnaire and sent my insurance cards and then didn’t hear anything. I had to call them several times, the story is that he’s negotiating with the payer and said I could call BCBS. I went on the Independence website to verify my eligibility on the Independence website, called them again and offered to pay out of pocket until they hear from BCBS just so I could see the doctor and she said no, because it would look bad for the doctor to see a BCBS patient as direct pay and it could mess up their negotiations. I called Independence today and the rep said the provider accepts my plan and that there’s no change to his account that would indicate that he doesn’t. She said to call him again and if they won’t take me, to call back because it’s “weird” At this point I’m looking for another doctor, I wanted to see him specifically because he’s a specialist but it’s obviously not going anywhere. But my question is this, I’ve never heard of a provider refusing to treat an in-network patient because they’re renegotiating their fee schedule, and refusing to let them pay out of pocket because it “looks bad” to the payer. Is this common? Is it legal? Is it something I should report to BCBS that he’s turning away patients to get better negotiating terms? TL;DR Doctor won’t take my insurance even though he’s in-network and won’t let me pay out of pocket because it will mess up his negotiations with BCBS. submitted by /u/Icy_Deal_5669 [link] [comments]Read Morer/HealthInsurance