I have been trying to find out for a very long time now, if my previous PCP is in network or not (got new health insurance in 2021). Aetna cannot give me a straight answer, I get a different answer from them every time. Yes she is. No she isnt. As a result I have pushed off my yearly check ups because I want to stay with her if possible because she’s great, but scared of it being billed out of network.
She works in a larger chain of health clinics in the area. Aetna lists a lot of the doctors apart of this chain as In network. And I know for a fact that all doctors in this chain bill under one Tax ID. Several people from the clinic billing department have told me that if one doctor in this chain is in network, then they all are, because they all bill under the same Tax ID. So based on this I thought that my PCP is definitely in network.
So I called Aetna again and explained the situation. That I keep getting different answers if shes In network or not, but explained that all these doctors bill under the same Tax ID, so if one is in network then they all are. Aetna rep said no that’s not how it works, them being in network also depends on the NPI.
So I have no idea what to think. I’m really annoyed I’ve been pushing this off for over a year because they cant give me a straight answer. Any insight?
submitted by /u/pizzunk
[link] [comments]I have been trying to find out for a very long time now, if my previous PCP is in network or not (got new health insurance in 2021). Aetna cannot give me a straight answer, I get a different answer from them every time. Yes she is. No she isnt. As a result I have pushed off my yearly check ups because I want to stay with her if possible because she’s great, but scared of it being billed out of network. She works in a larger chain of health clinics in the area. Aetna lists a lot of the doctors apart of this chain as In network. And I know for a fact that all doctors in this chain bill under one Tax ID. Several people from the clinic billing department have told me that if one doctor in this chain is in network, then they all are, because they all bill under the same Tax ID. So based on this I thought that my PCP is definitely in network. So I called Aetna again and explained the situation. That I keep getting different answers if shes In network or not, but explained that all these doctors bill under the same Tax ID, so if one is in network then they all are. Aetna rep said no that’s not how it works, them being in network also depends on the NPI. So I have no idea what to think. I’m really annoyed I’ve been pushing this off for over a year because they cant give me a straight answer. Any insight? submitted by /u/pizzunk [link] [comments]Read Morer/HealthInsurance