why wont they accept new medicade patients ??

Question

i made a ppointment with a doctor for my toddler , i asked if she was accepting new patients and she said yes , well i call to change pcp's andthe lady through connect care said she wanst accepting new medicade patients , why did the doc say she was ? i really need to change ..my sons current pcp is a ******

Answer 1

same problem in my area. i had medicaid for pregnancy because my insurance expired 2 weeks before i had my baby. my baby was automatically enrolled in medicaid so i tried to find a doctor. it was hard i called everywhere. i found one doctor, but after 2 visits i didnt like her. i had my baby enrolled in his fathers insurance immediately.

many pediatricians have stopped taking medicaid. im not sure why, but they may have had trouble with payments.

Answer 2

I doubt it was intentional. The doctor may be accepting new patients but not new Medicaid patients. Doctors that accept Medicaid usually limit the number of new Medicaid patients they accept. I think it's because Medicaid pays them less than private insurance. They probably can't afford to take more than a certain number every year. And some insurance companies (I don't know if this applies to Medicaid) limit the number of patients a doctor can take so that they are not paying a lot of money to one doctor. That's a limit that the insurance company uses to help prevent insurance fraud.

Answer 3

I have tricare and have the same problem. The thing with these insurances is they do not pay full price for services rendered. And when the doctor accepts you as a patient, he or she cannot bill you for what your insurance does not cover. The doctor's office has to write it off. Sometimes, they write a whole lot off. For example, my u/s cost $700. Tricare paid $144. The doctor had to write the rest off. That is why they limit the amount of tricare or medicaid patients that they accept if they accept any at all. Keep looking, I managed to find an excellent pediatrician for my son.

Answer 4

The people that handle claims usually know better than the doctors what insurance they take. I would not take the doc's word for it since he doesn't deal with that as much. Most doc offices have a certain number of patients they take from each type of insurance (private companies, medicaid, military insurance, state insurance) and when they fill that number they stop taking new patients. The doc may not have realized he was full.
I would call again but talk to someone else. If you still can't get in then get a list of the docs that take medicaid and keep trying to get an appt.

Answer 5

He is being dishonest. Under the letter of the act it doesn't prohibit your employer from keeping the plan and you from keeping the job nor make your plan expire (but all do.) Once the grandfathered plan is gone, you have to take an Obamacare plan. In Massachusetts which has a plan that is a model for much of this, doctors are already starting to refuse the public plan. Worse, about the same number will be subsidized as now, from what I can tell, except for preexisting conditions (the one good thing about the plan which I think should be handled alone, and drop the rest.) Everyone else has to pay for insurance if their employer doesn't and the cost will go up. General medical costs per the CBO will also go up. The driving purpose for reform to many was to get the prices down but you can't do that by demanding 300 million people purchase insurance product.

Answer 6

This is more complex than it seems. Many very fine Docs can't keep practicing on Medicaid reimbursement. They need to hire staff to complete the ton of paperwork. Provide service and have reimbursement denied. I'm not saying it is right but it is more complex than just doc's with an attitude. When I don't get the answers I am looking for then I change care providers. I would send a letter to my case worker concerning the MD though and include a copy to the MD. It will get his/her attention.

Answer 7

Reimbursement rates are low, sometimes lower than the actual cost of services. That basically leaves the doctor in the position of providing services pro bono. Because of this, doctors have to take the position of limiting the number of patients they can accept with that particular method of payment.

Answer 8

Because the government doesn't reimburse doctors enough for medicaid. This is a problem in my area, too. Medicaid is great for people who don't have private insurance but it's not much help if they can't find a doctor!

Answer 9

Medicaid pays one of the lowest reimbursment rates to providers. A lot of doctor's choose not to accept it because they make more money, break even, with bigger, better funded insurance companies.

Answer 10

Many of my sons doctors have been forced to accept jobs elsewhere because Medicaid wasn't reimbursing them for services they rendered. I don't have Medicaid and never had to deal with them, so I don't know, maybe they're picky about who they let your son see. That may be the problem here.