(Some) Fancy pants doctors won't accept PPO from the exchange

[GladRagDahl]

76. Here's why

These services are going to be run like Medicare and Medicaid when it comes to government payments. Medicaid determines just how much they will pay for each of the services that you receive when you to a doctor. In order for that doctor to bill for your services, they have to hire a Medicaid insurance expert to handle the filing of those claims. Medicaid is notoriously slow in paying claims in many states. What’s more, they are known for changing billing codes or requiring billing code changes time and again because they don’t feel like a service should be billed under the code that it was originally assigned.

What’s more, Medicaid is cheap; it’s that simple. If you were to go to a doctor’s office and have a check up, it would cost you about $90. This covers the cost of the doctor’s time, the nurse or nurses that helped you as well as the office staff that checked you in, the rental of the office, etc. etc. Medicaid, however, might pay $30 for that same visit, which doesn’t come close to covering the necessary fees.

That is why you will often find offices that accept Medicaid often book their appointments at 10-minute intervals and they are often backed up. They want to make some money, while providing treatment for their patients but they have to book 3 times as many patients a day in order to accomplish this.

If you live in a state where you get excellent care while on Medicaid, then you probably live in a state where the payment for services is higher than normal. In these states you will find that a majority of doctors accept Medicaid. The truth is that, in any state, if every doctor accepted Medicaid, then the cost would balance out and the doctors that do accept Medicaid wouldn’t be hit as hard when they receive their payment from Medicaid.