Doctors Networks Coverage

Posts related to doctors and health insurance plans, in-network, and their support of health care reform.

Doctors should work nights and weekends

October 9, 2016 By Kevin Knauss Leave a Comment

Covered California has implemented several changes to health plans to increase the access of doctors for patients. All EPO and PPO members will be assigned a Primary Care Physician and they have lowered the office visit copay for most plans, in addition to the no cost office visits for preventive care. But the one accessibility challenge that has not been addressed is the office hours of most doctors. It would make far easier for health care consumers to get care if they could visit their doctor in the evening or on weekends.

Bay Area vacuum of health care providers

August 25, 2016 By Kevin Knauss Leave a Comment

It is a reasonable expectation to assume that when a family enrolls in a health plan through Covered California that there will be local doctors to address their health care challenges. Unfortunately, some health plans have a virtual vacuum of providers in fairly large communities. This is the case for members of Anthem Blue Cross PPO individual and family plans in Livermore, California. For one family, the nearest in-network pediatrician is over 15 miles away from their Livermore home.

Doctors use bait and switch tactics with health insurance networks

June 18, 2016 By Kevin Knauss 6 Comments

The narrow doctor networks of California’s individual and family health insurance plans are actually smaller than first thought as doctors use a bait and switch tactic to lure in patients and then bill for their services with “out-of-network” providers. The health insurance companies have little control over this practice that has a doctor listed as in-network for their health plan, but the services are actually billed by a facility that is out-of-network. This bait and switch tactic, aided and abetted by confusing online provider search tools and opaque billing statements and codes, leaves consumers paying more for health care services than they should.

We need open enrollment rules for Doctors and Hospitals

January 13, 2015 By Kevin Knauss 1 Comment

With the announcement that Blue Shield of California may be dropping Sutter Health physicians and hospitals from their list of network providers in Northern California, Blue Shield members are wondering if their health plans are any good. For all the good of health care reform under the Affordable Care Act consumers are learning that doctors […]

Counselors urged to help LGBT members enroll in ACA

December 11, 2014 By Kevin Knauss Leave a Comment

The federal government is reaching out to behavioral health counselors and therapist to educate them on how the Affordable Care Act works so they can encourage members of the LGBT community to enroll in an ACA health plans. Sometimes the professionals who provide important health services through health plans offered through Healthcare.gov and CoveredCa.com can be the […]

Health Net’s new skinny EPO and HSP networks

December 5, 2014 By Kevin Knauss Leave a Comment

While Covered California was preparing a large press announcement with the California Medical Association (CMA) about extolling the number of physicians that are participating in Covered California individual and family health plans, Health Net was releasing their list of providers in their new narrow network Exclusive Provider Organizations (EPO) and Health Service Plans (HSP). A search […]

Concierge health care comes to south Placer County

October 21, 2014 By Kevin Knauss 2 Comments

Some folks are fortunate enough to have a long-time family physician that is always there to assist with their health care needs. But in our fractured world of health insurance many families are unable to develop a long term relationship with a doctor. A growing trend is for individuals, families and even businesses to establish a relationship with […]

Health Net restricts provider networks on Covered California plans

October 6, 2014 By Kevin Knauss 2 Comments

There was tremendous confusion over which doctors were in-network for the new individual and family plans offered through Covered California in early 2014. While the major health insurance plans offering PPO and EPO plans maintained the provider networks were the same regardless of whether they were purchased on or off the exchange, doubts persisted fueled […]

Acupuncture for all, my trip to the acupuncturist

April 22, 2014 By Kevin Knauss 1 Comment

All new ACA health plans include acupuncture as a covered health care service in California. So what is it like to receive acupuncture and can it potentially help relieve medical challenges that some of us face? I decided to try out this traditional Chinese medicine to see if it would alleviate the pain in my neck.

Greedy doctors kick patients out of their practices

March 24, 2014 By Kevin Knauss 2 Comments

California doctors, upon finding that the new Covered California health plans may not reimburse them enough to maintain their vaunted lifestyle, are kicking existing patients with the new health insurance out of their practices. These doctors are the epitome of the maxim “Putting profits before people.” Most of these greedy doctors haven’t exercised the common decency to notify their current patients before their appointments that unless they have the right color of health insurance, they won’t be served.

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Doctors Networks Coverage

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