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Insurer Admits Nearly 1,000 Doctors Wrongly Placed On Covered California Provider List
sanfrancisco.cbslocal ^ | April 22,2014 | No Attribution

Posted on 04/22/2014 1:09:51 PM PDT by MeshugeMikey

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To: MeshugeMikey

how does one mistakenly list 1000 ..of.anything “

We get calls from patients all the time who call wanting an appt and state that one of my doctor clients is listed in their network. Networks are combining at a rate never before see, providers are never notified that they used to be in Network A which has now been taken over by Network B to form new Network C. No paperwork, no authorization from doctor.

Doctor’s office staff have to try and keep on top of all of this which is often almost impossible. Most doctors don’t even know where a copy of their original contract is or any of the small print that it contains which allows networks to move the docs as they wish. Only recourse is to resign from the new network but in the intervening 3 to 6 months they may be forced to see those patients. Then they may find they still can’t get rid of them because of a medical liability issue.

It is all a hopeless mess and one of the reasons why so many docs are getting out of the insurance business totally before everything totally collapses.


21 posted on 04/22/2014 1:46:39 PM PDT by Grams A (The Sun will rise in the East in the morning and God is still on his throne.)
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To: MeshugeMikey
It appears unicorns have trouble tying with those little hoofs and simply made a few mistakes.

That's OK. Their intentions were good. It's now fixed.

Unfortunately, so are the people who signed up for this fraudulent "insurance" scam thinking they were going to actually see a real doctor.

22 posted on 04/22/2014 1:46:48 PM PDT by Gritty (Gun controllers aren't afraid of guns but a country where the individual has power-Dan Greenfield)
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To: MeshugeMikey

and 17 MILLION Americans were “inadvertently” listed as insured...


23 posted on 04/22/2014 1:48:58 PM PDT by Tennessee Nana
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To: MeshugeMikey
what comes after a smidgeon?

Jot & tittle.

24 posted on 04/22/2014 1:52:12 PM PDT by Graybeard58 (There is no peace, saith the Lord, unto the wicked.Isaiah 48: 22)
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To: Grams A
Why is this so much worse in some states than others? For example, in my state (WA), it is not that bad, if it is a problem at all. Although I frequently post articles from the Seattle Times and Seattle PI about Obamacare issues in the state, I am not aware of "wrongful listing of provider issues". Would not be a surprised if there were a small number due to ordinary data mistakes. It is true that some enrollees were surprised that certain hospitals were not covered but they were correctly listed as not covered.

Also, our exchange pretty much worked and still does (some teething issues early on). However, payment rate by enrollees has been below expectations -- 65-70% roughly.

Nothing out of the ordinary has occurred in my family's appointments since the first of the year. In fact, nothing really changed at all once you get in the examining room. Rx same way.

I do pray as always that contraceptive coverage gets shot down. I do not think my plan has abortion coverage although the Democrat state legislatures are trying to mandate it.

25 posted on 04/22/2014 1:59:28 PM PDT by steve86 (Acerbic by nature not nurture)
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To: steve86

You don’t have abortion coverage Steve? Sounds like a comrade health commissioner needs to pay you a visit and explain to you the patriotic need for that coverage ... or else!


26 posted on 04/22/2014 2:12:03 PM PDT by RetiredTexasVet (Watching MSM news readers pimping His Arrogance is like watching a dog eat its own vomit!)
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To: MeshugeMikey

You can bet that nationwide, not a single doctor was accidentally omitted from a provider list.


27 posted on 04/22/2014 2:23:25 PM PDT by proudpapa (Scott Walker - 2016)
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To: steve86
Why is this so much worse in some states than others?”

IMO, part of it is because the people who are administering all of this don't know what they are doing. Generally each state has their own regulations and there is absolutely no consistency from one state to another. Provider lists are shared within insurance companies and within networks.

There has been a huge growth in the types of plans available and each of these different plans, although all of their claims may be paid by the same insurance carrier, may and probably does have a different provider network.

No one ever is taken off of a list. I have doctor clients who may have been in practice for 20 years in 5 different locations and all that info is still in the “current” system.

Was so much easier to administer when there were no networks, everybody had the same deductible and everything was paid at 80% with a 20% co-pay. It all began to go in the toilet many years go but destruction really escalated when Clinton came up with HIPAA.

Then there is the issue of deciding whether something must be pre-approved or managed by a case manager. Just another level of bureaucracy and expense.

28 posted on 04/22/2014 2:42:43 PM PDT by Grams A (The Sun will rise in the East in the morning and God is still on his throne.)
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To: MeshugeMikey

If someone without connections to a corrupt White House did this, it would be fraud and prosecuted as the serious felony it is.


29 posted on 04/22/2014 2:55:49 PM PDT by Pollster1 ("Shall not be infringed" is unambiguous.)
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To: MeshugeMikey

“A Smidgeon of corruption here,....A Smidgeon of corruption here,....

what comes after a smidgeon?”

A Whitewash. Nothing to see here folks, you right wing conspiracy nuts move along.


30 posted on 04/22/2014 3:50:28 PM PDT by wildbill (O)
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To: wildbill
thas racess we can no longer accept the racess use of words such as "VV)(1☦e wash"....
31 posted on 04/22/2014 4:40:51 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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To: Pollster1

theres a key out there somewhere that will unlock the door to the prosecution , removal from office of one buraq hussein obama.

Where and what it is just hasn’t been made apparent YET.


32 posted on 04/22/2014 4:43:15 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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To: proudpapa

Doubtless not. DOUBTLESS not!

Pray we find and act on the GOODS on The Hussein Obama regime and soon.


33 posted on 04/22/2014 4:44:55 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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To: Tennessee Nana

frankly given what we’ver seen from this bunch, Im surprised that the number of “insured” hasnt already exceeded the size of the population.


34 posted on 04/22/2014 4:48:46 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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To: MeshugeMikey

Obama will not be removed from our White House until January 20, 2017 at the earliest. The Democrats care more about power than they do about the rule of law, and the Republicans care more about being treated nicely by the far left media than they care about the rule of law. We are stuck with the communist in power until Inauguration Day (at best).


35 posted on 04/22/2014 4:50:06 PM PDT by Pollster1 ("Shall not be infringed" is unambiguous.)
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To: Gritty

theyll be lucky to get backyard fence advice from a Boileroom.”Customer Service”..Phone Bank In Pakistan


36 posted on 04/22/2014 4:51:19 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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To: Grams A

a more sorry state of affairs is REALLY hard to imagine.

My condolances on being sideswiped!


37 posted on 04/22/2014 4:54:15 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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To: MeshugeMikey

This is only half the story.

The other half is the thousands of Californians that have no idea, or are just finding out, that they have signed up for health insurance that they had no idea was actually ObamaCare.

The doctor’s office my sister works at had all of their doctors falsely listed as ACA doctors, AND EVERY DAY they are getting more patients coming in that had NO IDEA that the insurance they’ve recently purchased was actually ObamaCare.

A great many of them are quite incensed.

Additionally, the doctors office has found that it is quite difficult to tell if the insurance presented is actually ObamaCare, without actually putting the account number through the system.

It appears that there has been rampant fraud, at least in CA, to sell ObamaCare insurance as Non-ObamaCare insurance.


38 posted on 04/22/2014 6:13:01 PM PDT by EasySt (Time to build that gulch...)
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To: EasySt

“Anthem-Care”? ,,,,


39 posted on 04/22/2014 6:23:24 PM PDT by MeshugeMikey ( "Never, never, never give up". Winston Churchill)
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