Just switched to a new Aetna plan this year. I’ve been trying way too hard to find out if my previous PCP is still in network, we will call her Dr. J. Heres the timeline of events:
Dr. J is not found in the list of in-network providers for my plan online. It does not say she is out of network, I just, cant find her at all
I call someone at Aetna. She said Dr. J is not in-network, but she would still be covered from balance billing (? Not sure if I understood this correctly)
I call the providers health clinic (UW) explaining I am looking for a new PCP because mine is not in network anymore. The receptionist tells me that if one provider at UW is in network, then they are all in network because all providers at UW are billed under the same tax code. Receptionist encourages me to call Aetna back and clarify
I call Aetna back and tell them that, and person says “haha, no, that’s not how it works, each doctor is billed under a different ID”. Then I proceed to ask again if Dr. J is in-network, just for the heck of it. To my surprise, this person says yes she is in network
I call Aetna again the following morning just to confirm what I had heard last night. And this new person says yes, Dr. J is in network
Meanwhile I had emailed my “health pro advocate” for our work company who is supposed to help me find this type of info out. She finally got back to me. She says no, Dr. J is not in network. According to her email, she gets her info from checking an insurance web directory. I wonder if it’s the same one I’m using.
So…..? What do you think
I wanted to get an appointment booked this week and am unable to do so because I cant find out an answer to this very SIMPLE question.
Which list is more likely to be most updated…the list on my Aetna page or the list the Aetna workers use?
submitted by /u/pizzunk
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Just switched to a new Aetna plan this year. I’ve been trying way too hard to find out if my previous PCP is still in network, we will call her Dr. J. Heres the timeline of events:
Dr. J is not found in the list of in-network providers for my plan online. It does not say she is out of network, I just, cant find her at all I call someone at Aetna. She said Dr. J is not in-network, but she would still be covered from balance billing (? Not sure if I understood this correctly) I call the providers health clinic (UW) explaining I am looking for a new PCP because mine is not in network anymore. The receptionist tells me that if one provider at UW is in network, then they are all in network because all providers at UW are billed under the same tax code. Receptionist encourages me to call Aetna back and clarify I call Aetna back and tell them that, and person says “haha, no, that’s not how it works, each doctor is billed under a different ID”. Then I proceed to ask again if Dr. J is in-network, just for the heck of it. To my surprise, this person says yes she is in network I call Aetna again the following morning just to confirm what I had heard last night. And this new person says yes, Dr. J is in network Meanwhile I had emailed my “health pro advocate” for our work company who is supposed to help me find this type of info out. She finally got back to me. She says no, Dr. J is not in network. According to her email, she gets her info from checking an insurance web directory. I wonder if it’s the same one I’m using.
So…..? What do you think I wanted to get an appointment booked this week and am unable to do so because I cant find out an answer to this very SIMPLE question. Which list is more likely to be most updated…the list on my Aetna page or the list the Aetna workers use?
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