Update on Duane, by Duane
Subject: Duane's Update!
A forum for Ohio educators interested in bringing needed reform to our pension system (STRS Ohio). John Curry (strswatchdog@yahoo.com) researches many issues related to STRS Ohio and contributes them to this blog. Contributions from others are welcome, and may be sent to Kathie Bracy (kbb47@aol.com).
Have you ever wondered why some doctors are in a network and some are not? There are two reasons:
(1) Those doctors, who are not in the network, are not  willing to practice medicine with an insurance company telling them what they  can and can not do for a patient.
(2) Those doctors in a company's network get paid a subsidy  for each patient of that company that they treat, but the procedure must be  according to the insurance company's wishes or some of the subsidy is taken  away.
Some doctors in networks are good doctors to their patients  because they find a way around the rules or are willing to lose some money.  Others do not want to play those games and I can understand why, so they choose  not to join networks. Sometimes an insurance company drops a doctor because that  doctor has refused to let a patient go without whatever care is  needed.
This information comes to me from a nurse who at one time  managed a GP's office and is now working for an insurance company as an  investigator on providers.
Shirlee
Labels: OEA, STRS, STRS Board
| Larry Kehres | Mount Union Collge Division III  |