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Are independant doctors able to survive?

June 25, 2014

Earlier this year Sharp Community Health Group turned away Anthem patients. Patients who obtained a new individual plan from Anthem in 2014 were told they could pay cash or seek another provider. This was not always easy since Anthem did not contract with Scripps or UCSD. That meant the patient could possibly find a doctor at Sharp Rees Stealy. That information was very difficult to find. They might have just gone ahead and paid cash to the Sharp Community doctor. The new Anthem plans are called EPO which means there is NO out of network benefit. The patient was really on their own.
In January and February the story from Anthem and Anthem Sales changed often and without apology. There were at least 15 codes that might lead you to the conclusion that your doctor accepted the Anthem insurance. At the end of this, you can conclude that if you purchased an Anthem individual plan in 2014, you would not be able to go to Sharp Community, Scripps, Arch partners, and Graybill Escondido.
Many of the doctors would explain that if the patient had an HMO they would accept that.
You should ask by now, as I did. WHY? According to some very reliable sources, Anthem cut their fees to the physicians by 30%. This did not happen in the HMO fees. I think a good comparison would be a strike. However like the grocery store strike, patients will take their medical records and walk. They do have some alternatives.

Filed Under: Networks, News & Commentary

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About Rhonda Norton

Rhonda Norton is the President at Hughes-Norton Insurance Services Inc.. Rhonda has been a Health Insurance Agent for 16 years and is a member of San Diego Health Underwriters, California Association of Health Underwriters and The National Association of Health Underwriters.

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