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cateyemm
Twins!
Member since 7/10 8027 total posts
Name:
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dr b- insurance
I called this morning and they told me they will no longer be accepting Empire BCBS as of June 28 and then he will no longer accept ANY insurance. I asked her why and she didnt answer. If you have out of network coverage, they can bill the companies and you are responsible for deductible and coinsurance.
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Posted 5/31/11 11:38 AM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
Torts
LIF Toddler
Member since 9/10 494 total posts
Name:
me
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Re: dr b- insurance
I was just going to come on here and ask the same Q about dr. B.
I referred a friend to him and apparently she was turned away because of insurance. I'm going to pass this info on to her. Thanks so much for posting this!
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| Posted 5/31/11 12:31 PM |
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Leb
LIF Adult
Member since 12/09 4166 total posts
Name:
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Re: dr b- insurance
Any insurance at all???
Why wouldn't he accept insurance?
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| Posted 5/31/11 1:13 PM |
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Sunny10
LIF Adult
Member since 10/10 1287 total posts
Name:
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Re: dr b- insurance
Wow! I suppose he is going to lose a lot of patients.
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| Posted 5/31/11 1:16 PM |
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LoLaBlue
PARTY OF 5
Member since 6/10 6900 total posts
Name:
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Re: dr b- insurance
 nice of them to tell me that when I called this morning!
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| Posted 5/31/11 1:22 PM |
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keepingsecrets
ridiculously blessed!!
Member since 7/09 1912 total posts
Name:
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Re: dr b- insurance
i was there this morning and they told me the same thing about my insurance--the last day is 6/28 and then i can only see him if i have out of network coverage (which luckily i will as of 7/1). when i asked him about it last week, it seemed like his plan was to drop most, if not all, insurances. he said it's become so tedious for the office and dealing with the insurance companies is not even worth the time involved b/c they don't pay him what it costs to do his this work. unfortunately i think this happens a lot. one of my favorite obgyn's ever ended up dropping all insurance companies too.
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| Posted 5/31/11 1:22 PM |
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Sunny10
LIF Adult
Member since 10/10 1287 total posts
Name:
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Re: dr b- insurance
Posted by keepingsecrets
i was there this morning and they told me the same thing about my insurance--the last day is 6/28 and then i can only see him if i have out of network coverage (which luckily i will as of 7/1). when i asked him about it last week, it seemed like his plan was to drop most, if not all, insurances. he said it's become so tedious for the office and dealing with the insurance companies is not even worth the time involved b/c they don't pay him what it costs to do his this work. unfortunately i think this happens a lot. one of my favorite obgyn's ever ended up dropping all insurance companies too.
The insurances never pay what the dr bills, but this is nothing new. I don't understand why now he is dropping all insurances. 
Those using out of network need to be aware that it is still going to cost you for deductable, coinsurance. On top of that, you are the one that gets the insurance check back instead of the dr, which is a small fraction of what you pay, so it adds up fast of paying a good amount out of pocket.
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| Posted 5/31/11 1:29 PM |
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Jax430
Hi!
Member since 5/05 18919 total posts
Name:
Jackie
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Re: dr b- insurance
It is very frustrating. He no longer takes GHI, and they were able to work something out with me for my consult on 6/11. I have out of network coverage, but they raised my deductible from $200 to $2500 starting tomorrow!!!! I am staying with Dr. B right now b/c I will be starting IVF and don't have coverage anyhow, but if I was still doing IUIs, I'd have to change. It's so stressful to have to switch from a doctor with whom your comfortable, but I think he will be losing a lot of patients!
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| Posted 5/31/11 3:05 PM |
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SecretTTCer
LIF Adult
Member since 6/08 2284 total posts
Name:
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Re: dr b- insurance
Posted by Sunny10
Posted by keepingsecrets
i was there this morning and they told me the same thing about my insurance--the last day is 6/28 and then i can only see him if i have out of network coverage (which luckily i will as of 7/1). when i asked him about it last week, it seemed like his plan was to drop most, if not all, insurances. he said it's become so tedious for the office and dealing with the insurance companies is not even worth the time involved b/c they don't pay him what it costs to do his this work. unfortunately i think this happens a lot. one of my favorite obgyn's ever ended up dropping all insurance companies too.
The insurances never pay what the dr bills, but this is nothing new. I don't understand why now he is dropping all insurances.
Those using out of network need to be aware that it is still going to cost you for deductable, coinsurance. On top of that, you are the one that gets the insurance check back instead of the dr, which is a small fraction of what you pay, so it adds up fast of paying a good amount out of pocket.
Not necessarily true. The doctor can choose to just accept the check that the insurance issues without the patient having to make up the difference. This is what Dr. Kofinas does for those of you who know him.
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| Posted 5/31/11 3:58 PM |
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PreshusSmurf
So in love with my little guys
Member since 1/07 2963 total posts
Name:
Jess
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Re: dr b- insurance
I'm so sorry you all have to add this headache to the struggle of IF.
I hope that those of you who have decided to switch find a doctor that you feel comfortable with and who helps you achieve your goal.
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| Posted 5/31/11 4:07 PM |
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Sunny10
LIF Adult
Member since 10/10 1287 total posts
Name:
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Re: dr b- insurance
Posted by SecretTTCer
Posted by Sunny10
Posted by keepingsecrets
i was there this morning and they told me the same thing about my insurance--the last day is 6/28 and then i can only see him if i have out of network coverage (which luckily i will as of 7/1). when i asked him about it last week, it seemed like his plan was to drop most, if not all, insurances. he said it's become so tedious for the office and dealing with the insurance companies is not even worth the time involved b/c they don't pay him what it costs to do his this work. unfortunately i think this happens a lot. one of my favorite obgyn's ever ended up dropping all insurance companies too.
The insurances never pay what the dr bills, but this is nothing new. I don't understand why now he is dropping all insurances.
Those using out of network need to be aware that it is still going to cost you for deductable, coinsurance. On top of that, you are the one that gets the insurance check back instead of the dr, which is a small fraction of what you pay, so it adds up fast of paying a good amount out of pocket.
Not necessarily true. The doctor can choose to just accept the check that the insurance issues without the patient having to make up the difference. This is what Dr. Kofinas does for those of you who know him.
Yes, that is true. Some doctors will accept the check, but if not, it adds up quick. Some people don't know they get back reasonable and customary amount. If Dr. B is dropping insurance due to the amount the insurance is paying him, wouldn't him accepting the check that was issued to the patient be the same thing though? 
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| Posted 5/31/11 4:07 PM |
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curiousO
he is here.. thank you God
Member since 10/07 2344 total posts
Name:
Me
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Re: dr b- insurance
unfortunately, it is the trend now in NYC. Good drs take cash only. Some awesome ob gyns do that and dr B is now following this trend. My ob gyn is out of the network for all insurances as well, but thank god, out of network benefits cover me. this sucks though
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| Posted 5/31/11 4:13 PM |
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MrsKS
Thank You St. Gerard.....
Member since 12/09 8306 total posts
Name:
Kerri
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Re: dr b- insurance
Posted by SecretTTCer
Not necessarily true. The doctor can choose to just accept the check that the insurance issues without the patient having to make up the difference. This is what Dr. Kofinas does for those of you who know him.
Dr Kofinas has insurance issues as well. I tried to see him and couldn't. I was told he is "in litigation with GHI" and was no longer accepting that insurance. (I have GHI for dr visits and BCBS for hospital related stuff.)
I really wanted to see him as a peri.
But it's really sad to read this about Dr B!!
Message edited 5/31/2011 4:14:42 PM.
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| Posted 5/31/11 4:14 PM |
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MrsKS
Thank You St. Gerard.....
Member since 12/09 8306 total posts
Name:
Kerri
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Re: dr b- insurance
Posted by curiousO
unfortunately, it is the trend now in NYC. Good drs take cash only. Some awesome ob gyns do that and dr B is now following this trend. My ob gyn is out of the network for all insurances as well, but thank god, out of network benefits cover me. this sucks though
It's tragic!!
Esp the "good dr's take cash only part".... so basically unless you have the dough you can't get good dr's to work with you. I think that's just awful!!!!
I HATE insurance companies... I think for the most par they are just scammers.
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| Posted 5/31/11 4:16 PM |
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LoLaBlue
PARTY OF 5
Member since 6/10 6900 total posts
Name:
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Re: dr b- insurance
Just got the call from his office letting me know about this.
I told her that I had gotten a letter from BCBS saying that it wouldnt happen until 9/30 & she was surprised!
she had NO idea what I was talking about & asked that I bring in the paper when I go in for my appt.
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| Posted 5/31/11 4:24 PM |
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bookworm
Two Little Rosebuds
Member since 8/09 2106 total posts
Name:
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Re: dr b- insurance
Posted by MrsKS
Posted by curiousO
unfortunately, it is the trend now in NYC. Good drs take cash only. Some awesome ob gyns do that and dr B is now following this trend. My ob gyn is out of the network for all insurances as well, but thank god, out of network benefits cover me. this sucks though
It's tragic!!
Esp the "good dr's take cash only part".... so basically unless you have the dough you can't get good dr's to work with you. I think that's just awful!!!!
I HATE insurance companies... I think for the most par they are just scammers.
ITA, but these are the doctors' choices to refuse coverage, not the ins. companies. everyone's asking why, why why? there's a simple answer: greed. i find it hard to believe these doctors are missing payments on their mercedes. especially since IF is big business, and they're able to bill up the yin-yang with all those monitoring appointments, in-house lab work, and the procedures on top it.
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| Posted 5/31/11 4:36 PM |
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LoLaBlue
PARTY OF 5
Member since 6/10 6900 total posts
Name:
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Re: dr b- insurance
Posted by bookworm
Posted by MrsKS
Posted by curiousO
unfortunately, it is the trend now in NYC. Good drs take cash only. Some awesome ob gyns do that and dr B is now following this trend. My ob gyn is out of the network for all insurances as well, but thank god, out of network benefits cover me. this sucks though
It's tragic!!
Esp the "good dr's take cash only part".... so basically unless you have the dough you can't get good dr's to work with you. I think that's just awful!!!!
I HATE insurance companies... I think for the most par they are just scammers.
ITA, but these are the doctors' choices to refuse coverage, not the ins. companies. everyone's asking why, why why? there's a simple answer: greed. i find it hard to believe these doctors are missing payments on their mercedes. especially since IF is big business, and they're able to bill up the yin-yang with all those monitoring appointments, in-house lab work, and the procedures on top it.
ITA! Infertility is big business & unfortunately we are the victims 
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| Posted 5/31/11 4:40 PM |
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td123
LIF Infant
Member since 3/10 294 total posts
Name:
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Re: dr b- insurance
I was reading this post and just wanted to add something regarding the out of network portion. Most insurance carriers pay out of network at a rate of 80% of the bill. This is a significantly higher amount than the providers have agreed to under the insurance plans. For example if a person who has no insurance has $5000 worht of treatment. The patient is responsible for 5K. If that patient had insurance accepted tbyt the provider, the provider would accept reimbursement of around $1000 from the carreir and not bill you the remainder. But using out of network. The carrier pays the patient 80% or $4000 and the patient would be responsible for the remaining $1,000. Some doctors will just accept the 80% and not charge you the remainder bc it is still much higher than what they would have paid if they accepted the insurance plan. Some doctors wont. You should ask how he will approach it with his new system.
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| Posted 5/31/11 4:41 PM |
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alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
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Re: dr b- insurance
Posted by td123
I was reading this post and just wanted to add something regarding the out of network portion. Most insurance carriers pay out of network at a rate of 80% of the bill. This is a significantly higher amount than the providers have agreed to under the insurance plans. For example if a person who has no insurance has $5000 worht of treatment. The patient is responsible for 5K. If that patient had insurance accepted tbyt the provider, the provider would accept reimbursement of around $1000 from the carreir and not bill you the remainder. But using out of network. The carrier pays the patient 80% or $4000 and the patient would be responsible for the remaining $1,000. Some doctors will just accept the 80% and not charge you the remainder bc it is still much higher than what they would have paid if they accepted the insurance plan. Some doctors wont. You should ask how he will approach it with his new system.
I got billed out pf Network for my last appt with dr B and he charged me the entire share of my portion.
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| Posted 5/31/11 4:48 PM |
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Sunny10
LIF Adult
Member since 10/10 1287 total posts
Name:
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Re: dr b- insurance
Posted by td123
I was reading this post and just wanted to add something regarding the out of network portion. Most insurance carriers pay out of network at a rate of 80% of the bill. This is a significantly higher amount than the providers have agreed to under the insurance plans. For example if a person who has no insurance has $5000 worht of treatment. The patient is responsible for 5K. If that patient had insurance accepted tbyt the provider, the provider would accept reimbursement of around $1000 from the carreir and not bill you the remainder. But using out of network. The carrier pays the patient 80% or $4000 and the patient would be responsible for the remaining $1,000. Some doctors will just accept the 80% and not charge you the remainder bc it is still much higher than what they would have paid if they accepted the insurance plan. Some doctors wont. You should ask how he will approach it with his new system.
I wanted to add my experience with out of network. I have 80% coverage out of network, but it is what the reasonable and customary amount is. So for something that I pay $2,800 for, their reasonable and customary is $190. Yes, $190. So I get 80% of the $190 and not the $2,800 I paid. I just wanted to share so nobody has any surprises. If the dr accepts the check, then they take the cut, but if they don't it falls on the patient.
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| Posted 5/31/11 4:52 PM |
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Sunny10
LIF Adult
Member since 10/10 1287 total posts
Name:
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Re: dr b- insurance
Posted by Sunny10
Posted by td123
I was reading this post and just wanted to add something regarding the out of network portion. Most insurance carriers pay out of network at a rate of 80% of the bill. This is a significantly higher amount than the providers have agreed to under the insurance plans. For example if a person who has no insurance has $5000 worht of treatment. The patient is responsible for 5K. If that patient had insurance accepted tbyt the provider, the provider would accept reimbursement of around $1000 from the carreir and not bill you the remainder. But using out of network. The carrier pays the patient 80% or $4000 and the patient would be responsible for the remaining $1,000. Some doctors will just accept the 80% and not charge you the remainder bc it is still much higher than what they would have paid if they accepted the insurance plan. Some doctors wont. You should ask how he will approach it with his new system.
I wanted to add my experience with out of network. I have 80% coverage out of network, but it is what the reasonable and customary amount is. So for something that I pay $2,800 for, their reasonable and customary is $190. Yes, $190!! So I get 80% of the $190 and not the 80% of the $2,800 I paid. I just wanted to share so nobody has any surprises. This is only my experience with BC/BS. If the dr accepts the check, then they take the cut, but if they don't, it falls on the patient.
Sorry this double posted. 
Message edited 5/31/2011 4:57:28 PM.
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| Posted 5/31/11 4:55 PM |
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SecretTTCer
LIF Adult
Member since 6/08 2284 total posts
Name:
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Re: dr b- insurance
Posted by Sunny10
Posted by SecretTTCer
Posted by Sunny10
Posted by keepingsecrets
i was there this morning and they told me the same thing about my insurance--the last day is 6/28 and then i can only see him if i have out of network coverage (which luckily i will as of 7/1). when i asked him about it last week, it seemed like his plan was to drop most, if not all, insurances. he said it's become so tedious for the office and dealing with the insurance companies is not even worth the time involved b/c they don't pay him what it costs to do his this work. unfortunately i think this happens a lot. one of my favorite obgyn's ever ended up dropping all insurance companies too.
The insurances never pay what the dr bills, but this is nothing new. I don't understand why now he is dropping all insurances.
Those using out of network need to be aware that it is still going to cost you for deductable, coinsurance. On top of that, you are the one that gets the insurance check back instead of the dr, which is a small fraction of what you pay, so it adds up fast of paying a good amount out of pocket.
Not necessarily true. The doctor can choose to just accept the check that the insurance issues without the patient having to make up the difference. This is what Dr. Kofinas does for those of you who know him.
Yes, that is true. Some doctors will accept the check, but if not, it adds up quick. Some people don't know they get back reasonable and customary amount. If Dr. B is dropping insurance due to the amount the insurance is paying him, wouldn't him accepting the check that was issued to the patient be the same thing though?
NO! The out of network amount is much more than the contracted amount an in network provider gets paid!!! It is likely more than triple the amount.
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| Posted 5/31/11 4:56 PM |
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Sunny10
LIF Adult
Member since 10/10 1287 total posts
Name:
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Re: dr b- insurance
Posted by SecretTTCer
Posted by Sunny10
Posted by SecretTTCer
Posted by Sunny10
Posted by keepingsecrets
i was there this morning and they told me the same thing about my insurance--the last day is 6/28 and then i can only see him if i have out of network coverage (which luckily i will as of 7/1). when i asked him about it last week, it seemed like his plan was to drop most, if not all, insurances. he said it's become so tedious for the office and dealing with the insurance companies is not even worth the time involved b/c they don't pay him what it costs to do his this work. unfortunately i think this happens a lot. one of my favorite obgyn's ever ended up dropping all insurance companies too.
The insurances never pay what the dr bills, but this is nothing new. I don't understand why now he is dropping all insurances.
Those using out of network need to be aware that it is still going to cost you for deductable, coinsurance. On top of that, you are the one that gets the insurance check back instead of the dr, which is a small fraction of what you pay, so it adds up fast of paying a good amount out of pocket.
Not necessarily true. The doctor can choose to just accept the check that the insurance issues without the patient having to make up the difference. This is what Dr. Kofinas does for those of you who know him.
Yes, that is true. Some doctors will accept the check, but if not, it adds up quick. Some people don't know they get back reasonable and customary amount. If Dr. B is dropping insurance due to the amount the insurance is paying him, wouldn't him accepting the check that was issued to the patient be the same thing though?
NO! The out of network amount is much more than the contracted amount an in network provider gets paid!!! It is likely more than triple the amount.
I am only sharing my experience with my insurance and my center. Everyone's insurance is different. I know after the coinsurance is met, it changes to 100%, but before that, for me, it is 80% reasonable and customary, which is a fraction of what I paid. And it took quite a lot of procedures before my coinsurance was met!
Message edited 5/31/2011 5:30:54 PM.
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| Posted 5/31/11 4:59 PM |
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SecretTTCer
LIF Adult
Member since 6/08 2284 total posts
Name:
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Re: dr b- insurance
Posted by bookworm
Posted by MrsKS
Posted by curiousO
unfortunately, it is the trend now in NYC. Good drs take cash only. Some awesome ob gyns do that and dr B is now following this trend. My ob gyn is out of the network for all insurances as well, but thank god, out of network benefits cover me. this sucks though
It's tragic!!
Esp the "good dr's take cash only part".... so basically unless you have the dough you can't get good dr's to work with you. I think that's just awful!!!!
I HATE insurance companies... I think for the most par they are just scammers.
ITA, but these are the doctors' choices to refuse coverage, not the ins. companies. everyone's asking why, why why? there's a simple answer: greed. i find it hard to believe these doctors are missing payments on their mercedes. especially since IF is big business, and they're able to bill up the yin-yang with all those monitoring appointments, in-house lab work, and the procedures on top it.
Wow! This isn't true at all. Insurance companies dictate how doctors treat patients. For example, we have all seen posts on LIF about someone having to do 12 IUIs before the doctor can do an IVF. Ridiculous. They can audit records, delay or refuse to pay the doctor, and of course, pay the doctors pennies on the dollar. In order to make a living and pay staff and the expensive equipment these offices require, the doctor is forced to take a zillion patients if they are in network. Doctors who accept insurance need to hire an entire staff just to submit insurance forms. The great doctors who can have a practice without insurance are able to practice medicine the way they want. I don't think it is about greed. It is about being able to practice medicine with independence from insurance companies. Patients who cannot afford private pay or who don't have out of network, can just go to someone who does accept insurance.
Also I wouldn't hate doctors who drive Mercedes. Most of them have student loans approaching a half million dollars. Most of them don't start making six figure salaries until they are in their 40s. If the compensation isn't worthy of the sacrifice then the profession would never be able to attract the best and brightest.
Message edited 5/31/2011 5:05:08 PM.
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| Posted 5/31/11 5:04 PM |
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InShock
life is good
Member since 10/06 9258 total posts
Name:
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Re: dr b- insurance
Posted by SecretTTCer
Wow! This isn't true at all. Insurance companies dictate how doctors treat patients. For example, we have all seen posts on LIF about someone having to do 12 IUIs before the doctor can do an IVF. Ridiculous. They can audit records, delay or refuse to pay the doctor, and of course, pay the doctors pennies on the dollar. In order to make a living and pay staff and the expensive equipment these offices require, the doctor is forced to take a zillion patients if they are in network. Doctors who accept insurance need to hire an entire staff just to submit insurance forms. The great doctors who can have a practice without insurance are able to practice medicine the way they want. I don't think it is about greed. It is about being able to practice medicine with independence from insurance companies. Patients who cannot afford private pay or who don't have out of network, can just go to someone who does accept insurance.
Also I wouldn't hate doctors who drive Mercedes. Most of them have student loans approaching a half million dollars. Most of them don't start making six figure salaries until they are in their 40s. If the compensation isn't worthy of the sacrifice then the profession would never be able to attract the best and brightest.
Exactly!
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| Posted 5/31/11 5:30 PM |
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