Question:
Surgeons are opting not to take insurance?

What is with this? I have seen on a couple of profiles where some surgeons have stopped taking insurance all together. They actually make more money for taking insurance, but is this a case of them not wanting to hassle with insurance approval? Or, perhaps something else having to do with their skill as a surgeon, (or lack thereof?)    — [Anonymous] (posted on September 7, 2001)

September 7, 2001
I disagree with your statement that surgeons actually make more money by taking insurance. The surgical fee part of my surgery was billed at around $5000, and because my surgeon was part of the insurance network and therefore under contract to take their price, he only got $1500. It's much more financially advantageous for them to get the whole fee from the patient. On the other hand, that may lessen their load since the insured patients would likely stay away then, but I guess it depends on which type of patients they have most available.
   — Tracy L.

September 7, 2001
Drs don't make more money working with insurance. I'm sure its a culmination of things that are drawing them to not take insurance.. most often they drop one or two kids.. i.e. they keep Aetna and Blue Cross but drop Lifewise etc.. they often drop those that are the most costly to maintain. Each contract the provider has with insurance typically requires some form of contactual payments. They get paid less by insurance because they are forced to take certain allowables, but at times the allowables are higher than they bill as well so hopeufully it can wash out.. all too often though they end up taking a loss. Its easier to take private pay or indemnity type of policies because the payments are better, the limitations aren't so stiff. I think more and more physicians will move away from contracting with all carriers and may just stay w/ the heavy players.
   — Dawn R.