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Re: Apple Girl

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Yes. Not replying to a post but to a question from Applegirl a few

weeks ago.

Great-West Healthcare

> 10.13.2006. Not on the web site yet. Got the letter today.

>

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That's amazing. I read your reply to Jan, in explanation of why you posted

this. My new insurance is Great West. Are you taking specific levels of

that, or some particular level of it? This IS my new insurance.

Apple Girl

> Great-West Healthcare

> 10.13.2006. Not on the web site yet. Got the letter today.

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I'm on the PPO.

Re: Apple Girl

>

> In network effective 10.13.2006. Not on the web stie yet. Got the letter

> from provider relations

> on Friday. The PPO plan only [i think] Maybe now I can do something

> about his designation as in

> network on Quaker. He was with that practice in 1999. We actually have

> gone in network for

> several new companies of late [in Texas and out of Texas] and in process

> with others. There are

> several not so good things a foot for docs in Lubbock that relate to who

> and how they do business

> [provider plans, ancillaries, hospitals]. We are part of a group that is

> standing for independent

> choice of the doc and what company he does business with. There are some

> things coming up in the

> next legislature that will negatively affect the business side of medicine

> [all over Texas] and we

> are trying to position ourselves to make a positive response. Doc is a

> delegate to The Texas

> Medical Association from West Texas and a member of the West Texas Caucus.

> The medicine is so

> easy. The business is so hard!

> Sharon

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Do you have an "open plan" where you can see any doc in the network without a referral? Dr. R is classified as a primary care doc, not a specialist. On most plans, about the only way to see him in network is to designate him as your PCP. wrote: I'm on the PPO. Re: Apple Girl> > In network effective 10.13.2006. Not on the web stie yet. Got the letter > from provider relations> on Friday. The PPO plan only [i think] Maybe now I can do something > about his designation as in> network on Quaker. He was with that practice in 1999. We actually have > gone in network for> several new companies of late [in Texas and out of Texas] and in process > with others. There are> several not so good things a foot for docs in Lubbock that relate to who > and how they do business> [provider plans, ancillaries, hospitals]. We are part of a group that is

> standing for independent> choice of the doc and what company he does business with. There are some > things coming up in the> next legislature that will negatively affect the business side of medicine > [all over Texas] and we> are trying to position ourselves to make a positive response. Doc is a > delegate to The Texas> Medical Association from West Texas and a member of the West Texas Caucus. > The medicine is so> easy. The business is so hard!> Sharon __________________________________________________

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Yes, it is an open plan, as long as we stick to in network docs. That is exactly how I'd do it. No referral. It's going to pay much less for an out of network doc.

Re: Apple Girl

Do you have an "open plan" where you can see any doc in the network without a referral? Dr. R is classified as a primary care doc, not a specialist. On most plans, about the only way to see him in network is to designate him as your PCP. wrote:

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I called Great West, and they said that it was ok for me to see Dr. R as in

network.

However, my new PCP just called Dr. R's office, and was told that they don't

accept Great

West. I'm not sure what the problem is, but I will try to get it straightened

out later today.

applegirl

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I'm sure wondering who that was that answered the phone there because it was

who just informed us that they do accept it, and she is IN Dr. R's

office. I'm sure wondering about your PCP??? Competitive in some way???

Hmmm. Not with MY body they wouldn't be, and if I found out this PCP was

not telling the truth, I would let him/her know in person that I know.

Re: Apple Girl

>I called Great West, and they said that it was ok for me to see Dr. R as in

>network.

> However, my new PCP just called Dr. R's office, and was told that they

> don't accept Great

> West. I'm not sure what the problem is, but I will try to get it

> straightened out later today.

>

> applegirl

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I emailed Sharon. She said that she had not yet informed all of the office people about the change, but will do that soon. wrote: I'm sure wondering who that was that answered the phone there because it was who just informed us that they do accept it, and she is IN Dr. R's office. I'm sure wondering about your PCP??? Competitive in some way??? Hmmm. Not with MY body they wouldn't be, and if I found out

this PCP was not telling the truth, I would let him/her know in person that I know. Re: Apple Girl>I called Great West, and they said that it was ok for me to see Dr. R as in >network.> However, my new PCP just called Dr. R's office, and was told that they > don't accept Great> West. I'm not sure what the problem is, but I will try to get it > straightened out later today.>> applegirl .

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I thought it was probably just a matter of not everyone in the office being

informed yet.

And if I thought for one second that my PCP was pulling something shady on me, I

would

certainly let them know. However, I just switched to a new PCP (had my 1st appt

with her

on Tuesday), and she is fantastic! Listened to everything I had to say, and has

already

made an appt for me to see another doctor here to help figure out exactly what

is going

on with me. She actually told me that the blood work I ordered online was

exactly what

she would have ordered! I told her about Dr. R, and the insurance situation,

and she had

no problem with me going to Lubbock to see him when the insurance would allow

it.

Thanks to everyone for your help. Your all great!

applegirl

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