What To Do About Doctors Refusing To Take Obamacare Blue Cross Blue Shield of North Texas.

[DhhD]

Several doctor's offices that I contacted today, gave me an office visit appointment at self pay. Calling on others doctor offices, I set up appointments for several weeks away, then told them I had BCBS insurance. The appointment was immediately dropped and the office worker said that the doctor was not accepting the Advantage Bronze Plan or any of the other three Advantage Obamacare Plans. I said that I would have to go to the emergency room and they would look into what happened, because BCBS would be responsible. Finally I had to call the PCP that is on the BCBS medical card and got an appointment as a self pay. When I go in to fill out the paperwork, she may refuse to see me when I write that I have insurance. I made printouts from the doctor's accepting new patients, Find A Doctor, BCBS web page.

Other people must be running into the same thing. I have been put on hold by BCBS using the ID number that leads to the Bronze Plan be paid for by the federal government subsidy. I have not been abble to get to talk to anyone for days, ever! Has anyone contacted healthcare.gov? Who would be the best contact in BCBS of North Texas?

[randys1]

1. You dont want to know what I think should be done to those

motherfucking racist piles of human shit who claim to care about human beings as long as what, they arent Black? (refusal to take ACA is just saying you hate Obama for being Black)

These fucking racist assholes, one of these days the good people of this country will have had enough

When will that be?

Turn these motherfuckers into the AMA, please.

[PoliticAverse]

3. The ACA plans may be paying the doctors less which might be the reason it is hard to find a doctor

accepting them.

[Hoyt]

5. Sadly, the AMA doesn't care.

[Warpy]

2. Doctors are now being reviewed online

Google the name and town. Then let them have it.

[PoliticAverse]

4. You may find the following article of interest:

http://www.nytimes.com/2014/03/15/us/white-house-tightens-health-insurance-standards-in-response-to-complaints.html

Note that currently insurance companies have to include only 20% of “essential community providers” in their service
area on their ACA marketplace plans.

[DhhD]

7. I went back online to one of the doctors, the taking new patients with Blue Advantage Bronze HMO,

her name and location had been removed from off of the goggle map but not before I downloaded the information that she was part of the 20% safeguarding the community.

They cannot hide anyway. All you have to do is call and set up a self pay appointment. The appointments are real easy to get within the next 7 days. You have the printout. All of theses people deserve to be exposed. They took the Hippocratic Oath. And the community relies upon them to provide for community workers who have no other way of having health care insurance. What will happens when these workers spread the flu around; one that the vaccines missed? One like Swine Flu that came up from Mexico in Spring of 2009? The whole community is at risk due to the hatred and greed of some local doctors.

[JayhawkSD]

13. The Hippocratic Oath does not require them to work without payment

Payment rates from some of the insurance plans are very low, lower than Medicare. If the doctor is being required to see patients for less money than it costs to run his office he will not remain in business and will not be treating any payients at all. Doctors have to pay their own bills and feed their families, too.

And it is the insurance companies which determines which providers will be included in their plans. The doctors did not necessarily choose not to be part of the "network" provided by the insurer, that "network"is drawn up bythe insurer.

"And the community relies upon them to provide for community workers who have no other way of having health care insurance."

What does that even mean?

[DhhD]

23. So self pay was insisted upon if you have a BCBS of TX card. And the county hospital district is

responsible for the reimbursement until Medicare and Medicaid and ACA make a decision. I am going to send the bill to the County Hospital District and apply for federal Medicare.

[GeorgeGist]

27. Wrong ...

Doctors agree or not to be in a network.

[DhhD]

29. By ACA law, 20% have to take Obamacare Plans. BCBS of TX decides who in its network the 20% are.

Next year it will be 30%.

If all doctors decided not to be in the network, then they could build their own hospitals of privilege based on self pay. And that is not possible.

[DhhD]

9. And the 20% are going against BCBS of North Texas in the case, it seems to me. The more I read,

the more I believe, that the CEO of BCBS of Texas needs to be contacted. The people being left out will have to go to the emergency room and BCBS will be responsible. If you are being denied care, find out online what hospital your PCP uses and go there to that hospital using your BCBS card.

[Kilgore]

6. Two different reimbursement standards

We have a BCBS plan purchased directly from BCBS, and my bro-in-law has the same plan purchased under Obamacare with subsidies. Our local family practice accepts our insurance with no issues, they will not see the bro-in-law who must travel to the next county to find a practice that accepts it.

I know our physician socially so I had the opportunity to ask why. Her answer was simply that Obamacare policies reimburse so little, it is not worth accepting them.

We are in Washington, but I assume its the same in Texas.

Kilgore

[DhhD]

8. Thanks for your reply. Wonder how many states are doing this?

[Kilgore]

10. It's national

According to our Doc another trend she has seen are "concierge practices" where the Doc's practice is limited to selected patients who pay an annual fee. Here is a link.

http://en.m.wikipedia.org/wiki/Concierge_medicine

She admits that she may go this way also just to get away from the hassles of dealing with insurance.

Kilgore

[Hoyt]

14. In other words, your doc friend wants to cater to well-to-do patients.

[Kilgore]

18. She appears not to be that kind of person

Family practice that's been around a long time and does lots of volunteer work in the community.

Highly doubt there is anything more than a desire to cover her costs. Probably will see her at our fireworks show. Will try to check it out.

Kilgore

[Hoyt]

19. Ask her if she takes Medicaid, Medicare, and how much lower Obamacare insurers are paying compared

to others?

Concierge care definitely cuts out everyone but the well-to-do.

Really not trying to be an ass, but I've worked with a lot of very conservative, right wing docs -- sort of like the Ron and Rand Paul types.

[Hoyt]

11. Most docs don't really know what they are reimbursing, they just assume it is low. Some

don't want poor folks sitting in their waiting room.

That is one major advantage to single payer - take it or go find another job that pays upwards of $150,000 annually.

[JayhawkSD]

12. Evidence please.

Please provide the surveys and documentation, along with the precise percentage of doctors who do not know what Obamacar plans pay, and of those what percentage refuse to accept patients without knowing what the payment rates are. The name of the surveying company and links are required.

[Hoyt]

15. Simple, ask them what Medicare, traditional BCBS, and Obamacare plans pay for 99213.

My bet is they don't know, but they know Medicaid and Obamacare cover a lot of poor patients, and they don't want any part of that.

Cite your studies to the contrary.

[JayhawkSD]

16. I haven't made any claims to the contrary.

I do not need to provide evidence for claims which I am not making. You are the one making claims; claims with no evidence. And now you are repeating them with a preface of "My bet is," which proves that you are making scurrilous, unfounded accusations.

And a "site" is a physical location. A "cite" is a quotion or a reference. Literacy is an asset.

[Hoyt]

17. Thanks for grammar lesson, but I changed it before you posted. You obviously have never worked with

physicians, or know how most of them make decisions on non-clinical matters.

You just want to bash Obamacare.

[JayhawkSD]

20. And again with the scurrilous, unfounded accusations.

My father was a physician, and many of my present friends are second generation physicians who are the children of his friends. I know very well how physicians make decisions on both clinical and non-clinical matters.

I have no interest in bashing Obamacare. Not fond of insurance companies, but unlike you, I have an interest in facts.

[Hoyt]

21. Fine. Show some facts on how Obamacare Plans are reimbursing vs. other plans.

[JayhawkSD]

22. See post number 6 and go away.

[DhhD]

25. I believe that the DU member in reply #22 is trying to get this thread locked down. ACA is a law.

[busterbrown]

28. “not fond of insurance companies?” Gee are you sure.?

Unless you feel that insurance companies are absolute scam artists who make profits off people’s miseries, you have no business posting in this forum....Profits off a person’s state of health..WTF?

[busterbrown]

30. Thanks man... Use to be 50 yrs ago Drs. were members of the community on all levels, making

house calls and seeing patients no matter what their financial situation was.. Today they seemed trapped in a bubble of self pity with insurance reimbursements.. Yup Drs. should live comfortable lives, but I thought their intentions in getting into medicine was because of the desire to serve humanity, not greed..

[DhhD]

24. I believe that reply #16 is off topic. I am hoping that #16 might self delete.

[dem in texas]

26. My daughter finally found a doctor over Euless that would take the plan

She has the same, the BCBS bronze from ACA. She could not find a doctor over in Arlington where she lives, the doctor she'd been going to would not take the plan. After many phone calls she did find one and seems happy with the results. Just don't give up, keep calling around.