Review: "Some Health Plans Have No In-Network Doctors in Key Specialties" – NPR
October 28, 2015
This was an article posted by Alison Kodjak of NPR. My response: yup, and we let insurance companies get away with this shit.
What would happen if you bought a computer and upon getting it home, it didn't contain a power cord? You'd be pissed. Especially since there's a picture of the power cord on the box, and so you expected to have a power cord when you got home. Otherwise, you'd have went with a different brand or just bought the damn power cord while you were at the store.
That's how this insurance racket is going. They never fully tell you everything when you buy the product, spending thousands of dollars only to learn that something you need isn't in the box and that that specialty power cord is the only thing that'll make your computer work. But you have to pay full price for it and can't get reimbursed.
It's infuriating to patients and to providers.
As I read through this article, they specifically mention that "the most common missing specialties were psychiatry, rheumatology and endocrinology."
Bravo my psych, rheum, and endo brethren! Keep fighting the good fight. Most people don't realize that the reason why folks in these specialties aren't in-network is because the contracts/reimbursements are terrible. Insurance companies want to keep all of their money; thus they will squeeze the docs to try and make this happen. Luckily, and sadly, there are few of us in those specialties so we don't have to be bullied into taking less money. So we walked.
Insurance companies then add insult to injury saying they won't cover a patient's visit "out of network," which would seem a bit unfair. Remember, the patient bought the box expecting the power cord. If there isn't one, can't the computer people at least offer a discount to the power cord purchased separately?
Nope. Not according to insurance companies. They say you can go out on your own, but you better still pay your premiums, or else.
P.S.Y.C.H. puts everyone on the same footing: generalists, subspecialists – the whole shebang. And we no longer have to worry about "networks" because everyone is "in" network. Now, let me be clear. There will likely be criteria that must be met and logged in the universal medical record before a subspecialist can be seen (I'll have to write a separate post about that later), but the access will be there.