Totaly confused on how to find a doctor

[Chicago526]

Okay. I have insurance, and my insurance company has a website that lists all the doctors that accept my insurance and that are taking new patients. I want a doctor at a particular hospital. I go to the hospitals website to find doctors at that hospital, then try and find them on my insurance website to see if they are with my HMO.

Every name I find on the hospital's website that I also find on my insurance website say that doctor is actually at a differant hospital than the one I want. I'm assuming the hospital website is correct (I'm sure they must know who works for them) and that my insurance website is wrong, but I'm totally confused by all of this. I've always been healthy and have never needed to find a doctor before so I have ZERO experiance dealing with doctors and insurance companies.

What is the easiest way to find a doctor at a particular hospital that accepts your insurance?

 

[Miss Jasmine]

We usually just get recommendations from family and friends. A lot of doctors here have privileges at both local hospitals, but we are a much smaller community.

 

[AllyandJack]

I'd isolate a doctor that you found on both websites and then call the doctor's office. They'll be able to tell you if they accept your insurance. If you want to be on the safe side, call the insurance company after that and confirm that you can see that doctor at that location. My insurance has this strange quirk that some doctors can't be seen at some locations, but can be seen at others. But, the doctor's office should be able to tell you with relative certainty that they accept your insurance and that you'll be covered when you see that doctor.

 

[Christine]

I'd find a few doctors that look promising and just give them a call. The receptionist will be able to tell you in about 2 seconds which hospital they use. Many times, depending on your area, they will go to multiple hospitals.

 

[Crankyshank]

I just search on my hmo's provider finder for doctors and normally they have a list of where they have admitting privileges. If they don't, I call my hmo's 800# and ask them if a doctor I'm interested in has Privileges at a particular hospital.

 

[Chicago526]

I'd find a few doctors that look promising and just give them a call. The receptionist will be able to tell you in about 2 seconds which hospital they use. Many times, depending on your area, they will go to multiple hospitals.

If they go to multiple hospitals, can I pick which one I'm seen at? The hospital I want is one of the top rated in the state, in fact it made US News & World reports top hospital list. The other hospital, on the other hand, has a very bad reputaion. Which is a shame, because it's 5 minutes from my house, the other (good one) is 20 minutes away.

And I can't ask for referances from friends and family, no one we know lives in our area. All my friends and family live in other towns and go to other hospitals.

 

[Christine]

If they go to multiple hospitals, can I pick which one I'm seen at? The hospital I want is one of the top rated in the state, in fact it made US News & World reports top hospital list. The other hospital, on the other hand, has a very bad reputaion. Which is a shame, because it's 5 minutes from my house, the other (good one) is 20 minutes away.

And I can't ask for referances from friends and family, no one we know lives in our area. All my friends and family live in other towns and go to other hospitals.

Pretty much, yes.

My OB/GYN practices at two hospitals and I can pick which one I want to have a baby in. Now, on an emergency basis you are either going to go where the doctor sends you or where your insurance sends you.

I also use a breast surgeon. He practices out of two hospitals (fortunately both pretty good). When I had surgery, I got to pick which place I could go to.

 

[TEENEE]

Unless you are having tests or some sort of reason to be admitted you would see the doctor in his or her office. If you were to need to be admitted to the hospital I don't think the doctor would have a problem with you chosing one hospital over the other as long as he or she has privelages at the hospital you are requesting.

 

[buzzlady]

I would just pick a doctor that you want to see. Doctors have privileges to the hospitals. The hospitals web site may list doctors that actually have an office in the hospital or only work in the hospital.

 

[The Mystery Machine]

You actually think websites and insurance lists are correct!
Seriously, never trust them or rely on them.

One time I did (in my younger days) and they MOVED...I did not think to ask where they were located, just assumed the info was correct. Never again...in fact now I ask and verify address to make sure.

Pick up the phone and start making phone calls is the easiest way.

 

[Chicago526]

Unless you are having tests or some sort of reason to be admitted you would see the doctor in his or her office. If you were to need to be admitted to the hospital I don't think the doctor would have a problem with you chosing one hospital over the other as long as he or she has privelages at the hospital you are requesting.

I'm looking for an OB/GYN who, when the time comes (not expecting yet but we're starting to plan), will be delivering my baby, so I want the good hospital, not the bad one! Otherwise, you're right, the hospital doesn't matter as much just for routine check ups!

 

[Crankyshank]

Unless you are sent via ambulance, you can go to whatever hospital you wish for treatment.
I was at the ER last thurs and went to the one 25min from home as opposed to the one 5min away. I routinely need blood work and tests done that my Dr isn't set up to do and I use a hospital in another state that my Dr doesn't even have admitting privileges to because my Mom and aunt work there and my Mom does the labwork for me and my insurance is accepted at that hospital. It would only be an issue if I needed to be admitted to that hospital.

 

[Chicago526]

The hospital has a toll free physician referal service, so I'll try calling them when I get home from work, it seems the info on the websites are just too conflicting to figure it out, at least for me anyway! I want to call now, but my co-workers love to ease-drop on phone calls, and they'd start spreading rumors I'm pregnant if they hear me trying to find a OB/GYN. Nice bunch of people but they love their gossip!

 

[mtemm]

a word of caution, just make sure that once you figure out a doctor, that you call the insurance company and make sure they are still on the list of approved doctors. I would go further and note the name of the person you speak to and the time/date, then file it away along with a printout of the doctor's name on the insurance website.

It sounds like overkill, but this is what I do now. When I was pg with my first baby, I knew what hospital I wanted to delivery at. I didn't want to tell people first so what I did was go on the message boards at parents place and parents soup for those mom's who had recently delivered in the past few months. I asked if anybody had delivered at the hospital I wanted to deliver at and what their experience had been, and if they would recommend their ob/gyn. I got a slew of responses, all positive for my hospital, and had several moms recommend this one particular doctor.

I double checked my insurance website and called to make sure this ob was part of my plan, then called to make an appt. Right after my first appt. I called the insurance company again (I think they told me to), and all was wonderful. I loved the doctor, I loved the practice, all is great, right? Again, that person had confirmed that my doctor was indeed on the list (I'm paranoid, I double checked).

Fast forward several months we started getting HUGE bills. They were billing as if the doctor was out of network. I double checked online and she was still listed, but when I called they said that things had changed that june 1st and she no longer was. Now, I had called June 14th or so to confirm everything was fine, and I thankfully had written the name of the person I spoke to down. We argued for a long time with the insurance company, and even pointed out that she was still listed on the website, etc, and after lots of discussion they agreed since I was in my 2nd trimester when all this came to light I could stay with her. but every month we got an enormous bill. Thankfully dh took over the calls and ended up with the direct extension of a supervisor who was the only person in the company who apparently could resolve things.

Funny thing...they never did remove her name from their list online. It was bizarre, I remember checking several months post partum (and no, things did not change).

anyway, sorry so long, but good luck and keep good records!!!!

 

[LadyyRedd]

If they go to multiple hospitals, can I pick which one I'm seen at? The hospital I want is one of the top rated in the state, in fact it made US News & World reports top hospital list. The other hospital, on the other hand, has a very bad reputaion. Which is a shame, because it's 5 minutes from my house, the other (good one) is 20 minutes away.

Actually, it depends. You need to find out if the doctor is in more than 1 medical practice. If he's in both Joe's Medical Group and Sam's Doctor Group and Joe's takes your insurance, but Sam's does not, you can't see him at the Hospital where he is practicing with Sam's.

Kimya