Because of all of the numerous ways a provide network search can give incorrect results, I am now recommending that people print out a list of providers in their area. Usually the list can be created in a PDF format that is searchable with Adobe Acrobat Reader. You can look through the list of doctor names alphabetically. You might see Dr. Balabat and realize that is your doctor when you thought the name was spelled Baladat.
One of the first filters in selecting an EPO or PPO individual and family plan, either through Covered California or off-exchange, is determining if your current doctor is in-network. For all the enhancements to online doctor directory search tools, they still suck. They are not consumer friendly. Consumers are given either too many conditions to select or the provider search tool offers too little information.
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.
Health Net of California announce on January 11th that because they were unable to reach agreement on reimbursement costs, specific Tenet Hospitals will no longer be a part of their network of service providers for certain Medicare, Medi-Cal and commercial health insurance plans.
Overall, the ad “thanking” Dan Lungren for fighting against new taxes on Medicare is extremely deceiving. H.R. 2190 proposes no new taxes.