3rd Trimester

Switching OBs at 26+ weeks

I was just looking at our insurance statements they send us. We were told by my OB's office that our insurance was in-network for them.

All of our bills (I just realized) say something about the out-of-network co-insurance maximums being met, and different discounts. I'm going to call tomorrow, but does that sound like they are actually NOT in-network?

Note: We've been receiving bills (totalling around $1500) from my OB, but didn't pay anything yet because we though maybe insurance just hadn't approved the charges yet.

Lauren has Down syndrome and a complete AV canal heart defect
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Re: Switching OBs at 26+ weeks

  • Call your insurance provider tomorrow and ask for confirmation. Then call your OB's office and ask to speak to someone in billing to clarify your OB's status with your insurer.

    It is possible to switch providers after 26 weeks, although your choices may be limited, as some doctors are hesitant to take new patients late in pregnancy. 

  • Oh my....that would stink if they didnt' cover your doc! I'd raise heck about it...
  • No kidding! We were told we were in network, otherwise I would've switched WAY sooner and not seen this doc at all. It looks like we've met our out of network deductible, but will obvioiusly still be switching. Looks like I have some calls to make in the am. I'm nervous.
    Lauren has Down syndrome and a complete AV canal heart defect
    Baby Birthday Ticker Ticker

    Baby Birthday Ticker Ticker

    image

    [url]WWW.MeetingLauren.blogspot.com[/url]
  • From someone in the medical billing business....if you were told that the MD you were seeing was in-network then I would not pay a penny of the out-of-network charges - they need to eat it.  If need be, write a letter stating that you "dispute the charges, as you were informed by the office staff that the MD was in-network".  If they send the bill to collections, again use the term "dispute" in your corresopondence....they are required to halt collection activity pending further investigation.   I would insist they write off the account and provide you with a statement showing a 0.00 balance.

    It's possible that something happened with the MD's participation status in error and no one in the office caught it.  Another situation may be that MD's get paid for some insurances more for out-of-network billing and they make a decision to accept whatever the insurance pays...and are not up front about the status of the participation of the MD's.  This may or may not be the case, but it is called network interference and may be considered to be illegal (some insurances are starting to crack down on this and go after those doing this ). 

    GL and don't be nervous....you have rights.

  • I switched at 30 because we moved.  And while I hated leaving behind the NP that did all of my 1st pg and this one to 30 weeks, it wasn't that bad.

    When you make your appointment with your new doctor you don't even have to tell them why, just that you need a new doctor.

    It sucks but it happens to women all the time, when they move, their employer switches insurances, etc.  I'm sure you'll find someone you like and a nice hospital.

  • I switched at 33 weeks because I moved. Today was the first time I saw my new OB. So far, I'm much happier with them than my old dr anyway. So it's possible, good luck with the charges and your new dr.
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