As a provider, how do network adequacy exceptions affect me? I recently opted out of Aetna, placing us out-of-network for a handful of existing patients. One of them is seeking an exception. Does this effectively put me back in-network? Aetna reimburses even less than Medicaid in my state and also comes with a very high administrative burden. Everything about this carrier is inconvenient and unintuitive.
If we end up doing the exception and the rest of the folks in this health group hear about it and want to do the same (small town, large employer with this coverage), will we essentially be back to engaging in-network with Aetna and accepting their low reimbursement?
Thanks for your help!
submitted by /u/PMHELL
[link] [comments]As a provider, how do network adequacy exceptions affect me? I recently opted out of Aetna, placing us out-of-network for a handful of existing patients. One of them is seeking an exception. Does this effectively put me back in-network? Aetna reimburses even less than Medicaid in my state and also comes with a very high administrative burden. Everything about this carrier is inconvenient and unintuitive. If we end up doing the exception and the rest of the folks in this health group hear about it and want to do the same (small town, large employer with this coverage), will we essentially be back to engaging in-network with Aetna and accepting their low reimbursement? Thanks for your help! submitted by /u/PMHELL [link] [comments]Read Morer/HealthInsurance