Doctor is in network at closed office but out of network at new one?
Apologies if this isn't the correct sub for this. Not sure where else to get answers…
I am wanting to return to a doctor that has opened a new office. He unexpectedly left his old location 2 years ago and I have been in panic mode about it ever since. The stress and anxiety from all of this is making my chronic illness symptoms worse. He recently opened a new private practice but my insurance (Anthem w/ my state's expanded medicaid plan) is not approving him at this location. I keep contacting both the doctor and insurance company but they keep telling me no updates yet. He is still listed as in network at the old location and has been trying to get the new one added for over 4 months but Anthem is not budging. Everytime I ask about it they tell me to have the doctor contact their provider services agent to update his listing but he has been doing that almost every single day. I also heard the directory automatically updates daily with info from the provider's npi number but even his npi number shows his new address. Why is it taking so long to be updated in Anthem's network?? How much longer do I have to wait?? I don't think I can keep dealing with this much longer. Idk what to do 😠my mom has offered to help me pay out of pocket if needed but I would much rather use my insurance because we are both tight on money.
I read somewhere I have the option to try for prior authorization for out of network approval if my pcp sends a referral but I don't think that will work because there are in network doctors in my area that treat my conditions. I refuse to see anyone else because they do not have the same level of care as this doctor. The treatments for my condition are controversial because most doctors rely on outdated research that has been disproven by expert specialists. I do not want to end up with someone who is going to gaslight me and make my health worse than it already is. Is there anything else I can do to convince Anthem to let me have my doctor back??
submitted by /u/Prudent-Weird-4959
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