Insurer directories incorrectly list providers as ‘taking new patients’
Outdated and inaccurate provider directories from insurers may list primary care physicians as available to new patients when they’re not. Those mistakes force patients to call hundreds of offices to find physicians who will take them.
Penny Gentieu of Toldeo, Ohio, told Kaiser Health News she called more than 300 physicians, all of which were listed as accepting new patients. She found more than 75 percent of them weren’t.
“It’s just not fair to be baited and switched,” said Gentieu, who must find a new doctor because her physician of several years will not be in any available plans in her area in 2017. “It’s just so crazy that you’re presented with this big list of doctors and then you call them and you realize there’s nobody there.”
Flaws in provider directories have become more pronounced as insurers leave the Affordable Care Act’s exchanges and networks become more and more narrow. The problems persist even though CMS has rules to punish providers with inaccurate directory information.
For more on why CMS isn’t enforcing those rules, and why a repeal of the Affordable Care Act likely won’t solve this issue, click on the link below:
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.