Patient abandonment?

amother

Wed, May 15 2024, 3:16 pm

My insurance changed due to DH's job loss. My kid sees a specialist and gets medication prescribed. We have an appointment coming up but they no longer accept the new insurance. They won't refill med unless he is seen.
They won't let us pay cash for the visit because my son is now on Medicaid.
The new insurance has a prior authorization process. Started that for a new office but we Can't book appointments without it. AND they have no appointments until September.

Are doctors allowed to just drop patients? Not give them access to medicine?

Amarante

Wed, May 15 2024, 3:32 pm

Some insurance companies allow continuity of care in these situations which enables someone to continue with a provider for a short period.

I don't know how Medicaid handles it but I would call someone to find out options which might also include getting an appointment very quickly with someone in their network.

amother

Wed, May 15 2024, 4:14 pm

Amarante wrote:

So how does continuity of care work?

amother

Navyblue

Wed, May 15 2024, 4:15 pm

amother OP wrote:

So how does continuity of care work?

You have to contact you insurance company for a special dispensation.

amother

Whitewash

Wed, May 15 2024, 4:19 pm

amother OP wrote:

So how does continuity of care work?

That’s usually when a doctor becomes out of network with an insurance company the insurance will sometimes allow you to continue seeing he doctor for continuity of care in situations where it’s not simple to stop like pregnancy or cancer c’v. I don’t think switching insurances on your own would allow for that specifically because you can usually pay for cobra but you may be able to get Medicaid to cover out of network if they can’t provide you with a comparable specialist who can see you in network. In the timeframe you need medically.

anonymous mom

Wed, May 15 2024, 4:30 pm

Can you tell them you don't have insurance at all and want to pay cash? I don't see why they would decline that.

amother

Grape

Wed, May 15 2024, 4:57 pm

anonymous mom wrote:

Can you tell them you don't have insurance at all and want to pay cash? I don't see why they would decline that.

It's against the law for a dr to charge a public aid recipient for services. There are drs that allow it with signing waivers etc, but it really is illegal.

anonymous mom

Wed, May 15 2024, 4:58 pm

amother Grape wrote:

It's against the law for a dr to charge a public aid recipient for services. There are drs that allow it with signing waivers etc, but it really is illegal.

I wasn't aware of that. That is so frustrating! Now she's stuck!

amother

Kiwi

Wed, May 15 2024, 5:05 pm

Go see a doctor that’s within the new insurance network in the meantime .

amother

Olive

Wed, May 15 2024, 5:08 pm

amother Grape wrote:

It's against the law for a dr to charge a public aid recipient for services. There are drs that allow it with signing waivers etc, but it really is illegal.

Is this true in all states? I've never heard of this.

amother

Mintgreen

Wed, May 15 2024, 5:13 pm

I have this situation with an orthopedic. They didn’t let me have a follow up appointment even for cash. The issue got neglected until there were issues I went to another Dr and the child has big issues. I called them up mad and spoke to the Dr assistant anbout my problem. They called me back that they will see me with my new insurance. Very weird.

Lesson: push and make a big fuss.

I’m wondering if it’s legal that they take an insurance but prefer not to (big hospital system) so they they they don’t.

amother

Wed, May 15 2024, 5:39 pm

oneofakind wrote:

This might sound silly but can you go to the ER?

Unfortunately not something that they will do. It isn't emergent but if not treated can get long term medical ramifications.

We also didn't choose to do medicaid. We went for marketplace plan that covered this doctor. But kids got kicked off without warning because they were eligible for medicaid.

amother

Firebrick

Wed, May 15 2024, 6:52 pm

Have your PCP put in a referral to your Medicaid hmo for the specialist with a request for continuity of care
Where are you located?

amother

Wed, May 15 2024, 7:03 pm

amother Firebrick wrote:

Have your PCP put in a referral to your Medicaid hmo for the specialist with a request for continuity of care
Where are you located?

He did but I called the place while it is still processing. No appointments can be made until approved AND there are no appointments until September. Surprised

amother

Navyblue

Wed, May 15 2024, 7:11 pm

anonymous mom wrote:

I wasn't aware of that. That is so frustrating! Now she's stuck!

It depends on the state.

However, the laws are complicated and so I am not surprised that a doctor doesn't want to deal with self pay when they could possibly run afoul of state regulations.

A doctor doesn't have to see any patient - even if the accept Medicaid or any other insurance, they can not accept new patients for example.