THE WORST FEAR OF OBAMACARE, FOR DOCTORS HAS ARRIVED!!!

By Andrew Guzaldo

Amici Journal

  Doctors groups fear their members won’t get paid because of an unusual 90-day grace period for government-subsidized health plans and are urging physicians to check patients’ insurance status before every visit.

“This puts the physician and their patients in a very difficult situation,” said former AMA President Donald J. Palmisano.  The American Medical Association has advised Physicians recently  about how to minimize their risk.

“If a patient is being treated for a serious illness, that requires ongoing care,” he said. “The physician has to assume the financial risk for this. That’s the bottom line.” Reiterates Doctor Palmisano

If an enrollee in a subsidized plan falls behind on their premium payments, of Obamacare/Affordable Care Act requires insurers to cover their medical bills for 30 days. 

But for the next 60 days, insurers may hold off paying the claims, and ultimately, deny them if the patient doesn’t catch up on his premiums. That means doctors don’t get paid for their services, and if  the insured ends up canceling the policy after 90 days, doctors can bill patients directly but may face difficulty collecting.

“The doctors get left holding the bag on pending claims,” said a former insurance executive and consultant.

The way things work now, insurers generally cancel a policy if a subscriber falls behind more than 30 days. The insurer is usually on the hook for bills incurred before that cancellation.

The AMA and dozens of other physician groups have urged the Obama administration, to explain how and when insurers must notify physicians when their patients fall behind on premiums.

If the insurer notifies the physician that a patient is behind on premiums and the insurer is holding up claims payments, “Nine times out of ten the doctor is not going to provide the services, no matter what their network contract says.”

“The doctors are not the bad guys, it’s the Government ACA Health Care that has provided all these loops the Medical professionals have to jump through.  

For some medical specialties, treating patients who have fallen behind on their payments could end up being quite costly. And will in turn be up to the Doctors to go to their own collection agencies to recuperate their funds

Oncology practices that administer chemotherapy drugs have to purchase the medications, which can cost thousands or even tens of thousands of dollars. If a patient’s claims are not paid, the cost to the practice is high.

BOTTOM LINE= Doctors, have already indicated when they feel they will not get paid by the patient, or Obamacare/ACA they will deny treatment to the patient. Or they may demand payment prior to any treatment, which could also breach the existing contract with any or all insurers. Not to mention, the extended treatment may be needed longer that anticipated  

 This would mean lawsuits and extensive bills with Attorneys to fight for their rights.  Doctors/Physicians have studied for years not to become collection agency, for the Government but to treat, and heal those that are suffering with illnesses. As well as studying to find cures for existing causes!!

  Doctors’ groups had a notification law, passed earlier this month by the Washington state legislature.However it seems this will not help them when it comes to a patient that has not paid their bill?