Refusing to take insurance in private practice?

[FreudianSlippers]

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Lets say a psychologist has a job at a group practice called "Clinic A", and is paneled to take Aetna insurance. The psychologist then gets a part time job at "Clinic B", which is a fee-for-service clinic and does not take insurance. If the psychologist saw a client at Clinic B who happened to have Aetna, would this psychologist have to legally see them under the insurance policy, or could they treat them like a regular fee-for-service client?

 

[Doctor Eliza]

They would be obligated to let them use their insurance.

 

[FreudianSlippers]

That's what I thought....thanks Doctor Eliza!

 

[aly cat]

Actually I think it depends on the agreement. I only take private pay so I'm not that well versed-- but I have someone who subleases from me and he told me explicitly that (at least with BCBS) he was permitted to accept insurance at his "main" practice and decline to accept insurance for the work he does out of my office.

 

[PsyDr]

Completely dependent upon each individual insurance contract.

Only exceptions are Medicare/Medicaid.

 

[FreudianSlippers]

Actually I think it depends on the agreement. I only take private pay so I'm not that well versed-- but I have someone who subleases from me and he told me explicitly that (at least with BCBS) he was permitted to accept insurance at his "main" practice and decline to accept insurance for the work he does out of my office.

Ahhhh gotcha. So the take home is check with each insurance provider! That's super helpful, I wasn't sure if there was some sort of legal guideline overseeing this o rnot.

 

[WisNeuro]

Ahhhh gotcha. So the take home is check with each insurance provider! That's super helpful, I wasn't sure if there was some sort of legal guideline overseeing this o rnot.

As PSYDR said, there are guidelines for Medicare/Medicaid which say if you're in, you're in everywhere. But yeah, you'll have to get the contract of everyone you are credentialed with to figure it out for other carriers.