What to do doc question — The Bump
VBAC

What to do doc question

So I found this practice I really like and one of the docs doesn't work with my insurance.  The other 5 are in my network and I really like them they are VBAC friendly.  When I joined the practice (at 31wks because previous doc just left to another town with no warning) I knew the one didn't work with my insurance but assumed that I could say I don't want him delivering etc. 

Yesterday at apt was talking to billing about it and they stated you have to use whoever is on call.  This seems very unfair to me, how can you do that to patients 1 out of 6 doesn't accept the same insurance and I would have to pay Out of Net prices.

 I am sure there are other friendly VBAC docs but at 35 weeks I am just frustrated.  Anyone delt with this or have any good advice?

TIA ladies 

 

 

Re: What to do doc question

  • I would talk to the billing person at your OB's office. I was at a large practice where most but not all of the OB's were covered under my insurance. My insurer said that as long as they billed under their practice and not individually, then it wouldn't be a problem. And that's what my practice did. I am no insurance expert so I don't know how to explain it well, other than that. I think that some practices, especially larger ones, bill all their services under one practice rather than individually. Either way, talk to the OB billing person.

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  • imagemargeincharge2:

    I would talk to the billing person at your OB's office. I was at a large practice where most but not all of the OB's were covered under my insurance. My insurer said that as long as they billed under their practice and not individually, then it wouldn't be a problem. And that's what my practice did. I am no insurance expert so I don't know how to explain it well, other than that. I think that some practices, especially larger ones, bill all their services under one practice rather than individually. Either way, talk to the OB billing person.

    This.  Otherwise, it would be insane to expect people to roll the dice on whether they are paying a co-pay or out of network.

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  • According to my insurance and the billing person I spoke to on Fri they all bill under their own taxpayer id not as a practice.  I will double check tomorrow, I agree it is insane and I wish I would've looked into this more earlier!
  • imagespring06:
    According to my insurance and the billing person I spoke to on Fri they all bill under their own taxpayer id not as a practice.  I will double check tomorrow, I agree it is insane and I wish I would've looked into this more earlier!

    The OB office I worked in could only bill by individual dr, nothing as a practice, so unfortunately, that may be a risk you will have to take. Are you able to find out their schedule so you know what the chances are of that dr delivering you?

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  • I can try but I don't know if I am willing to take the risk of having to pay that much.  I am going to try to talk to one of the doc's and billing tomorrow.
  • I guess you'll get more answers from you OB. If I recall, the OB charge is really low. The biggest bill came from the hospital. So the out of pocket should just be the OB charge, right? Still not an insignificant amount but something to keep in mind if it means this practice is where you'll most likely be able to vbac (which is cheaper than a c/s too).

    I hope everything works out. It seems absurd that a practice like that would have different insurance for different doctors and require you to take whoever is on call. That is a predicament.

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  • It is only if it is a c-section an issue and they won't charge me, they will attempt to recover from ins company so all is well. 

    Thanks for the advice ladies.

  • I'm glad you got it resolved!
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