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    Default Insurance Woes

    Hi,

    I currently have a Medicare Advantage plan that allows me to see doctors out of network and the doctor that I am seeing out of network for almost two years, is my Rheumatologist. This plan will not be continued in 2013 and the only option I have is to join this insurance provider's HMO plan, which will not allow me to see out of network doctors.

    The insurance provider has a program called "In For Out Option" which would allow me to see an out of network doctor The criteria for this program is that "the physician, has to be the only doctor in my area who can provide this service"

    This is what the insurance provider wants the doctor to say or something similar to that and I quote "I am the only provider within the patient's area that can provide this service for her".

    Do you have any suggestions/comments as to how to modify this statement, if the doctor doesn't feel comfortable making this definitive statement?
    Last edited by beeinformed; 11-30-2012 at 07:33 PM.

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