Reply to DC Psychiatrist Falsely Represented That He Is Cash-Only OON

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Reply to "DC Psychiatrist Falsely Represented That He Is Cash-Only OON"

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]OP here. The odd thing, especially, is that I now know from the in-network EOB that the negotiated rate is $228. So my doctor was engaged in all these shenanigans for an extra $22 per visit. I assumed the in network reimbursement had to have been much lower. [/quote]

Clinician here.   Reimbursements are sad, insulting and not a livable wage. I am out of network for this reason. I don’t know why someone who is in network would say they aren’t.   Is it possible that they don’t know they are in network? Might they have been credentialed with their previous employer without their knowledge? Stranger things have happened.  I would communicate my concerns with a provider before reporting them to the board.  I would hope that your relationship would warrant doing so.  
[/quote]

I assumed it was a mistake. I contacted the provider and asked if there was any chance he was in-network with my insurer. He said that he is and that if I'd like to go in-network moving forward that we can. I know he's not oblivious to my insurance situation because he literally had a phone call with my insurance company early on about what information he needed to include in his super bill because the first claim got denied twice for inadequate information.

The comment you're responding to demonstrates that the reimbursement in this case is less than 10% off his cash rate ($228 per 30 minute telehealth visit). I'm surprised anyone would risk it for a less than 10% benefit. [/quote]

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