I’m so confused. I need go to a specialist asap. There are only a few practices in my area that are in network. For some reason, the doctors at those practices that I can get in with asap are not showing up as in network with my plan in my portal. The doctors that are showing up in network in my portal are booking months out. the practice itself is coming up in network.
I have no out of network benefits at all.
I asked my insurance who told me to ask the offices if they bill by practice or doctor. I then asked the billing office of these practices this question and have gotten very confusing and conflicting answers. Some have told me they bill by the practice, while others told me they bill by the doctor. Some have told me all their doctors are in network with my plan, but my insurance has confirmed my portal is accurate that the doctors I can book with are not.
I don’t know what to do or if I go to the out of network doctors at the in network practices?
Thanks
What happens if you go to an in network practice, but the doctor you see is out of network?
byu/etahtidder inInsurance
Posted by etahtidder
1 Comment
Most of the insurance plans I’ve had allow you to go out of network, but you have to pay more for doing so.
If your plan does not allow you to go out of network at all, you would have to pay the full uninsured rate which is very high.
It’s always best to call the doctor’s office to verify they are in network as many of the insurance websites are not updated regularly.
It’s odd that the offices are telling you they are in network but insurance is telling you otherwise.
I did have an issue like this not that long ago with my mom’s dental insurance. As they had told me they were in the network, they honored the network price.