General Discussion

frazzled

(18,402 posts)

37. Yeah, but the first hit is a total fail

Tue Nov 19, 2013, 11:18 PM

Nov 2013

First, it was written before what it admits were the release of any official plans. And if you read down:

Dr. Jeff Rideout, senior medical adviser for the Covered California state exchange, said some insurers have built networks that are “wholly new and created for the exchange” while others are using networks identical to their current products. He stressed that all plans included in the exchange had to get state and federal regulatory approval for network adequacy. Covered California says the 12 plans approved for its exchanges include 80% of the state's doctors and hospitals.

http://www.modernhealthcare.com/article/20130817/MAGAZINE/308179921

Gosh, 80% of the states' doctors and hospitals too small a network for you?

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(Some) Fancy pants doctors won't accept PPO from the exchange [View all] flamingdem Nov 2013 OP

$100 > $0 Paulie Nov 2013 #1

The problem is that some are known to be the best for flamingdem Nov 2013 #4

I'm a little confused. What do you mean by ACA payments? Incitatus Nov 2013 #41

This doctors office will only accept plans that are independent flamingdem Nov 2013 #42

The same thing happened with the roll out of Medicare. nt tsuki Nov 2013 #46

Piratesmile posted something about that flamingdem Nov 2013 #48

There is no standard "ACA" payment. OrwellwasRight Nov 2013 #52

Also in California. I think it will work out. NYC_SKP Nov 2013 #2

Do you think the mini-crisis is the confusion about ACA flamingdem Nov 2013 #10

I think "many more in the system" is a red herring. I think non-PCPs are edgy about being paid. NYC_SKP Nov 2013 #12

Aha! Good and optimistic analysis flamingdem Nov 2013 #14

Docs want to get their share just like other greedy participants in health care system. Hoyt Nov 2013 #3

Here's the crazy thing - these fancy doctors DO take Medicare flamingdem Nov 2013 #6

Lots of doctors take Medicare, but not Medicaid. Nye Bevan Nov 2013 #17

A lot higher in some states. Hoyt Nov 2013 #30

what you just said dlwickham Nov 2013 #35

Well I guess if they think the 1% will take care of them, then I say go for it Doc. notadmblnd Nov 2013 #5

The fancy doctors will stellar reputations are often fully booked flamingdem Nov 2013 #8

Well then I guess you wouldn't have a chance of seeing one anyway, no? notadmblnd Nov 2013 #16

With my previous PPO that wouldn't be a problem flamingdem Nov 2013 #19

Then it's not an ACA thing and the ACA is not to blame notadmblnd Nov 2013 #23

I'm more pissed at the doctors than ACA flamingdem Nov 2013 #24

Seems to me that the most up to date Drs will be the ones who've recently gone into practice notadmblnd Nov 2013 #27

Certain doctors deal with the same issues over and over flamingdem Nov 2013 #39

Not necessarily. onyourleft Nov 2013 #68

It is NOT an "ACA policy." It's a regular insurance company policy. Lex Nov 2013 #7

I hope you're right. This is a question to ask one of the reps flamingdem Nov 2013 #9

Exactly. Viking12 Nov 2013 #11

Sorry, that is incorrect. Nye Bevan Nov 2013 #15

Source? Viking12 Nov 2013 #20

The policies and coverage must be identical. But not the networks. Nye Bevan Nov 2013 #22

There can be very different payment rates depending on plan and network. Hoyt Nov 2013 #43

No - that's not true. Yo_Mama Nov 2013 #36

Most of the policies on the exchange have much narrower networks Nye Bevan Nov 2013 #13

This could prove to be problematic flamingdem Nov 2013 #18

You have to do a lot of homework before choosing a plan. Nye Bevan Nov 2013 #21

I agree. I've already logged a number of hours on this flamingdem Nov 2013 #25

Your other option is to buy a policy off the exchange. Nye Bevan Nov 2013 #26

One of the ways that the Insurance organizations are keeping prices low on the exchanges... PoliticAverse Nov 2013 #28

Much more of a problem for Medicaid then Medicare. Nye Bevan Nov 2013 #31

One of the things the ACA did was to boost Medicaid reimbursement to be comparable to Medicare PoliticAverse Nov 2013 #34

This article is a good find flamingdem Nov 2013 #49

Sez who? frazzled Nov 2013 #29

How about a few thousand Google hits? Nye Bevan Nov 2013 #32

Yeah, but the first hit is a total fail frazzled Nov 2013 #37

Anthem's seems to be closer to 50% flamingdem Nov 2013 #51

50% not good? frazzled Nov 2013 #58

This issue has been widely discussed. Yo_Mama Nov 2013 #38

I'm beginning to wonder if this is more of the same flamingdem Nov 2013 #40

I wish I could find that article, because it discussed all the ins and outs Yo_Mama Nov 2013 #66

I think people underestimate the issues Medicare had to deal with but there was no cable news or Pirate Smile Nov 2013 #33

So if someone goes out of network their bill will be resolved in a couple of months ... slipslidingaway Nov 2013 #45

People need to look beyond the premiums to who is in your network ... slipslidingaway Nov 2013 #44

This is upsetting to me flamingdem Nov 2013 #47

"Gold" and "Platinum" do NOT mean better networks. Don't be misled. Nye Bevan Nov 2013 #56

Not sure how to answer your question ... slipslidingaway Nov 2013 #57

THere should be no fancy doctors in a healthcare system for all Rosa Luxemburg Nov 2013 #50

Say a successful doctor is netting $90,000 per year from his practice. Nye Bevan Nov 2013 #59

I've yet to see a doctor net $55,000 from their practice. Lex Nov 2013 #61

That would not be "greed." But, there are not many hardworking docs making just $90K. Hoyt Nov 2013 #70

Ignorant assumptions. Beausoir Nov 2013 #60

I can only imagine that Theodoric used trepaning flamingdem Nov 2013 #62

Staff should be hired by the state government including doctors Rosa Luxemburg Nov 2013 #78

How dumb. Trust me when I say that if you ever get sick, you do NOT want government trained Beausoir Dec 2013 #80

I hope you hit the sarcasm button Rosa Luxemburg Dec 2013 #81

I don't think it was "part of the plan" but rather something not fully addressed by the plan. hughee99 Nov 2013 #53

Besides, Kaiser is great! OrwellwasRight Nov 2013 #54

I've been using Kaiser for a couple of years. I like it. Problem is Hoyt Nov 2013 #65

Anyone who supports universal health care OrwellwasRight Nov 2013 #79

I can tell you UCLA, UCSF, and a lot of fine medical facilities in Ca lostincalifornia Nov 2013 #55

Thanks! I was planning on calling various departments at UCLA tomorrow flamingdem Nov 2013 #63

I may have misread some of the information. It is confusing. It implies only some of the plans lostincalifornia Nov 2013 #64

This UCLA bulletin lists a lot more plans - I'll call to be sure flamingdem Nov 2013 #69

Good, thanks lostincalifornia Nov 2013 #74

It was unfair to lock your thread flamingdem Nov 2013 #72

It was. I was concerned I gave incorrect information out in this thread, and was just to make lostincalifornia Nov 2013 #73

There have always been doctors who operate on a cash-only, no insurance basis. geek tragedy Nov 2013 #67

What's different - my "fancy pants" doctors won't accept my insurance company csziggy Nov 2013 #71

Related article: "Doctors are concerned about pay scales under health care law" PoliticAverse Nov 2013 #75

Here's why GladRagDahl Nov 2013 #76

sometime in the 90s... went from nonprofit state level bc/bs salin Nov 2013 #77