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When we had our first child, we carefully selected a pediatrician that was covered by our insurance. It turns out that doctor was only billable to our insuranc
by chapium 6y ago
When we had our first child, we carefully selected a pediatrician that was covered by our insurance. It turns out that doctor was only billable to our insurance for delivery, any follow up visits were not covered by the insurer because that same doctor was not considered part of that hospital org. The org she did routine pediatric work was somehow different, yet in the same building. We discovered this as we were leaving the hospital and scheduling a follow up visit. It was very urgent since we had a moderate complication and need a doctor immediately. However our insurer (employer provided) was blacklisted by the doctors group that all doctors in our neighborhood were a part of. Ultimately, on short notice we found a new pediatrician an hour away which began ordering lab work. This is not something you want to go through with a newborn and a new mother. It was also bullshit, because we were hit with a surprise caveat to our researched doctor so late in the process even though we had been trying to do our due diligence to get things squared away months in advance.
This was all because our insurer decided that our doctor was billed by different rules depending on what part of the job she was doing for the same patient. I've been an ardent supporter of single payer ever since.