Specialists & Insurance Coverage

[bracketbuster68]

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What role does insurance coverage play when a patient is referred from a GP to a specialist office? For example, If you are not in-network for a pt, does that play the most important role in whether or not they accept tx with you? Or do other things matter more: personality, practice branding/reputation, etc.

 

[Deep Impact]

They can play a role and I believe it’s become more important with people looking to reduce out of pocket expenses. Having said that, people will still seriously consider the GP’s recommendation since most have long term trust relationship with their GP. However, the GPs in my area tend to give out two or sometimes three choices for the patients to pick out. Then, it’s up to the patient to check the insurance network etc. Out of pocket expense can be substantial if say someone is pay out of pocket for wisdom teeth with IV sedation.

We have multiple offices and notice that socioeconomic status of the patient will dictate this pattern to a degree too.


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