Medical group canceled my drs contract

ck4567

I hope I can just VENT and let off some steam and get some opinions to help me gain some perspective. I know I need to just calm down because this anger is bad for the baby, and I am blessed to have this baby so really this isn't the end of the world, but it still really makes my blood boil.

So I found out at 4pm today that my dr is no longer covered by my insurance because my medical group cancelled him. I have an appointment with him Monday morning. They didn't give me any warning at all. Just said effective immediately. So now I get to pay cash for my appointment because I am not going to miss it due to this. I can fight the insurance on this because what they are doing is likely illegal. I have a law degree and I found a statute on my side. Or I can just find a new doctor. Sadly finding a new doctor is prob the best option because insurance company red tape is not something I want to be dealing with while pregnant or with a new born. Knowing my luck I'd fight for my doctor and then he wouldn't even be on call when I gave birth!

I should also note this medical group has pulled shady stuff like this in the past. I had to fight with them for 2 months to let me see a doctor I knew was in my network because they they insisted he was out of network despite much evidence to the contrary. I had to put a needed mri on hold for 2 months while they just kept giving incorrect information. During that time I had them email me a list of covered Obs in case I fell pregnant. Now they cancel the doctor I picked from that list. Nice.

I'm just so mad. I did not want to deal with this, and I thought it was all good since I found a dr. in my network. Anyone else have to change drs due to insurance issues out of your control? How did you stay calm?

Edit- at least I figured out paragraphs on the ipad. Just added the paragraph symbol to make paragraphs.

OlgaN15

That is definitely frustrating. I'm sorry you're going through that. We're going through something similar, but have until January before it comes into effect. I'm so glad it gives us enough time to switch insurance plans. I hope you're able to figure something out soon.

ck4567

And the worst part is I can't even have a fucking drink to settle down. Ugh

CTri17

that sucks, maybe see if they would cover for this pregnancy? Or look into changing dec1 ? insurance blows

hbn7614

Silver lining...at least now early on instead of at 8 months? I loathe insurance companies. Bunch of dickheads.

jjone10

Which una do you have?

a316b

Insurance companies are sometimes not the greatest. I'd look into switching Companies if you can? Most open enrollment periods are now-dec 1 to pick new coverage for the new year. I know my employer is giving us 3 options for next year, or you can always price out obamacare? It wasn't too unreasonable for my MIL.

As for doc- I'd totally keep the monday apt, but look for another doc that accepts most major medical plans and get on their books ASAP.

ck4567

@hbn7614‌ - yes, I am thankful this isn't happening later in the pregnancy!

@CTri17‌, @a316b‌ - I am going to decide after my appointment Monday if it's worth it to me to make a fuss to keep my current doctor until jan 1st and then I'll switch into a medical group that my current doctor does take. Luckily, I had many of the routine pregnancy tests already so there isn't much left to do until the new year except the anatomy scan. Sadly I can't just switch companies all together because this is all my work offers, and honestly I'd be scared to have obamacare while pregnant with all the changes it's going through. My work does offer a PPO, but it's just too expensive for us to afford.

I am just trying to stay calm for the baby. I am usually a calm person but dealing with insurance companies always raises my bp and gets me pissed. I told my husband he has to make all the calls from here on out because I get way too angry. And now I'm stressed about how much stressing I've done because I don't want to hurt the baby. I must end the cycle.

Thanks for the support, everyone. I am just imagining my baby in my arms and at that point hopefully I won't care what doctor I had because everything went fine and I'll have my baby!

queenhoneybee

Sorry you're dealing with this insurance nonsense. It's probably not worth the aggravation sticking with your original DR. Like PP suggested, I'd keep Mondays appt and switch into another medical group. I try to hold onto everything happens for a reason. Hoping you'll really like your new DR. Best wishes and try not to stress over things you don't have control over. On another note, where the paragraph symbol on the iPad? I can't find it anywhere!

ck4567

Thanks @queenhoneybee‌. I think you're right on, and the added stress isn't worth it. I'm mad at myself for getting so worked up.

To make paragraphs type in < p > after the last sentence in the paragraph, and then you press return and add another < p> on that line. Press return again and start your next sentence. But don't put any space between the < and the p . I just had to do that or it would not show up in this post. Maybe there's an easier way, but that's how I do it.

queenhoneybee

@ck4567‌- thanks so much, it's so much easier for me to bump from my iPad, but the shifting of the format is frustrating. 

Glad to read you're feeling better, sometimes all you need is a little time after an "incident" to help put things back into perspective. It's sometimes hard to remember when you're in the heat of the moment though. I'm working on it

JenGrl8503

Another thing to consider/discuss on Monday is whether it was the dr or the insurance group that initiated the change. Where I live, more and more doctors are electing to drop insurance companies and just go with the few that pay the best because they are so busy they can be selective either way, no fun! Sorry you are having to deal with this!

kimber9416

If your medical group is no longer associated with your doctor, that's not the ins company's fault. That is an agreement between the medical group and the doctor. If your ins company or plan no longer associate with your medical group or doctor, that's because their contract to be a provider for that ins company is no longer active (they could have not agreed on payment terms or prices, your doc could be billing over what is reasonable / standard compared to other doctors in the area, or the ins company could have received so many negative feedback calls about the doc that they no longer want to associate.) Either way it's your doctor's office that is responsible for contacting you about their provider status with your ins company. Also the ins company has to give the doc at least 30 days notice of a cancelled provider agreement - they had time to notify you. I agree that ins companies can be complicated to understand, but they are not always evil or at fault. This specific incidence, your issue should truly be with your doc / medical group and their communication with their patients about their status with a payer.

ck4567

@jengirl8503- the medical group canceled the doctor.

@marybeth080710‌ - I don't really think it's called obamacare, that's just a nickname, and I know what the ACA is and what it is for. But thanks for the clarification since I can see how you could assume I didn't based on my offhanded comment mentioning "obamacare." My issue is that's where I live doctor's do not contract or cancel contracts purchased through the exchange simply because they are associated with the ACA, and I don't want to deal with that while pregnant. Plus my work covers all my insurance premiums, and that's nice.

@kimber9416‌ - I have been dealing with the medical group not the overriding insurance company, maybe that was unclear from my post. I know the actual insurance company had nothing to do with this. I have also been trying to ascertain why I was given no notice, and my doctor said he also did not receive notice. I do not know if that's true, but my doctor told me the medical group won't return his calls and is acting very unprofessional. The doctor wants to stay with the medical group, but the medical group told me they cut him based on a "business decision." I understand that they have the right to cut him, but notice needs to be given properly and they could have waited until January 1st to ensure a smoother transition, that would have been the decent thing to do since the end of the year is so close. Medical groups do not always cut doctors "for cause", sometimes it's just to save money by getting some high cost people moved out of their medical group to another so they can save money.

I am trying to see if I can be extended care for 30 days from the date I was given notice, or at least for last Mondays appointment so I do not have to pay cash.The secondary issue beyond the notice is in my state there is a law stating even if a medical group cancels a doctor they must give continuous coverage to a pregnant patient, and the medical group is not cooperating in that regard, which is likely illegal. They should be informing patients of their right to continuous care with the canceled doctor until birth, not just telling them they have no options other than finding a new doctor or picking a new medical group (that would save them serious cash). The third issue that IS with my actual insurance company is whether I can switch medical groups now and be covered before January 1 because they have been giving me conflicting information about that subject, but that wasn't in the post.

But, it's all going to be what it's going to be. I am not stressing over it anymore. My husband is taking all the calls for me and one way or another I will have this baby. Thanks for all the feedback, everyone, I appreciate it.