so about a month ago my wife had an appointment with an oral surgeon for her wisdom teeth extraction. an appointment for the surgery was set up for next week.
i had called my insurance [CIGNA] to see how much would be covered and what was the patients responsibility under my plan. out of the total $3000 bill, we only had to pay $200 which is pretty good..
however, i called up the doctor’s office to confirm that and it turns out that at the time of the appointment he was contracted by CIGNA [in-network] but sometime after that he had requested CIGNA to remove him from the contract!!?? this of course increases our share.
i think the doctor should have informed us of this in advance or atleast should have honored his previous agreement with us.
has this happened to anyone? why would he risk losing a patient?
now there is another doctor who sits in the same office with him and is in network so the assistant offered that we could set up an appointment with him but we are not sure if we should return to the same office or not
Re: Doctor became Out Of Network after the initial appointment ?! (CIGNA)
I don't think its the doctor's responsibility to inform the patient of the change or inform the patient in general what network he is in. Whenever I have questions about doctors, my insurance always tell me to make sure its an in-network doctor. So I am pretty sure its not the doctor's responsibility.
Now in your case since it was a change after you made the appointment, not really sure how it work but I still do think its your responsibility to find out everything about the doctor.
Re: Doctor became Out Of Network after the initial appointment ?! (CIGNA)
^well, the weird thing is that my insurance still insists that that doctor is in-network and i will only have to pay $200...
Re: Doctor became Out Of Network after the initial appointment ?! (CIGNA)
so about a month ago my wife had an appointment with an oral surgeon for her wisdom teeth extraction. an appointment for the surgery was set up for next week.
i had called my insurance [CIGNA] to see how much would be covered and what was the patients responsibility under my plan. out of the total $3000 bill, we only had to pay $200 which is pretty good..
however, i called up the doctor's office to confirm that and it turns out that at the time of the appointment he was contracted by CIGNA [in-network] but sometime after that he had requested CIGNA to remove him from the contract!!?? this of course increases our share.
i think the doctor should have informed us of this in advance or atleast should have honored his previous agreement with us.
has this happened to anyone? why would he risk losing a patient?
now there is another doctor who sits in the same office with him and is in network so the assistant offered that we could set up an appointment with him but we are not sure if we should return to the same office or not
Where did you get this info that doctor dropped himself from contract?
Re: Doctor became Out Of Network after the initial appointment ?! (CIGNA)
^from his office
Re: Doctor became Out Of Network after the initial appointment ?! (CIGNA)
^from his office
You might want to ask why.
As you said no one want lose patient, but it is up to physician just like the patients to choose who they want o go with and who they do not want.
If you you find other physician who accepts your plan then go with that physician.
Morally the physician should have informed you though. But there must have been a legit reason why physician stopped talking your insurance.
I am sure you would not have cared for the doctor when deciding about your insurance carrier if you were given cheaper rate.
Re: Doctor became Out Of Network after the initial appointment ?! (CIGNA)
Go on your insurance website. They should have a list of in-network doctors. And honestly speaking I wouldn't go with this doctor. Why take chances when you can go somewhere else.