Another example of how patients don’t really know what goes on behind the scenes:
“At some point, the doctor can’t justify accepting an insurance that’s not meeting his cost of business,” Rietsema said. “The typical primary-care provider has an overhead of 60 to 70 percent. In the end, sometimes the doctor has no other choice” than to not accept a particular coverage.“Patients will think that they have good insurance coverage, but they don’t realize their doctor is not getting a reasonable compensation for their services,” he added.
When doctors do discontinue relations with a specific insurer, it is with the hopes that that action will force insurers to renegotiate their contract with the physician to provide better reimbursements, Rietsema said.
