Who can help me when I have a complaint regarding my doctor or doctor’s office (not partnering with me in my care, not respecting me, not listening to me, unresolved billing issues, etc.)?
The best approach is to schedule an appointment with the doctor’s office manager. Physicians strive to provide great service to their patients. The office manager is skilled in addressing any problems that arise.
How do I find a doctor that takes my insurance? I have called everyone in the “book”/directory I received, but no one is taking my insurance.
The directory you receive from the state when you sign up for insurance includes doctors who are contracted with the various insurance plans listed. Many physicians are not accepting new patients with government sponsored insurance plans because of very low payment rates. Thus, even though a physician is listed as accepting a government sponsored insurance plan, that does not mean he or she is accepting new patients insured by these plans.
Clark County has severe access issues for patients insured by government plans.
(A) Physician incomes in Clark County are considerably lower than much of the nation. Thus, Clark County has a shortage of primary care physicians.
(B) Government sponsored insurance plans offer reimbursement rates that do not cover the cost of providing care. Thus, many practices limit the number of patients they accept with these plans. Otherwise, physicians would spend more to run their businesses than they would bring in; their practices would fail. Hospital affiliated practices generally have better access for patients insured by government sponsored plans.
A list of clinics currently (as of 3/14/14) accepting patients with government sponsored insurance plans is provided below…
TRADITIONAL MEDICARE:
Family Medicine of SW WA
SeaMar Community Health Center
Urgent Medical Center
MEDICARE W/SUPPLEMENT:
Adventist: over 65 w/supplement
Ashbrook Medical Family Practice
SeaMar Community Health Center
Urgent Medical Center
MEDICARE ADVANTAGE PLANS:
Adventist
Ashbrook Medical Family Practice
Family Medicine of SW WA
Lacamas Medical Group
Rose Family Medicine, PLLC
SeaMar Community Health Center
The Vancouver Clinic
Urgent Medical Center
MEDICAID:
Adventist: CUP-plan (CHPW) only as secondary over 65
Family Medicine of SW WA
Lacamas Medical Group CUP and CHPW only for established patients new to AppleHealth or limited new patients as assigned.
SeaMar Community Health Center
Urgent Medical Center
NOTES:
Rose Family Medicine, PLLC:
RFM does see uninsured or underinsured patients at a 50% discounted rate for “pay-in-full-at-time-of-service”. The first visit is $150 and additional visits are $50 for 20 minutes. This is ideal for patients who are in-between insurances, are uninsured, or have a high deductible.
Urgent Medical Center:
UMC is currently still accepting new Medicaid patients. They open/close this panel according to their percentages and payor mix.
I have just moved into the state/We are bringing my parent(s) up to live in the area – what/who can I talk to about insurances and doctors?
SHIBA (Statewide Heath & Insurance Benefits Advisors) – 360-735-3686 or 800-562-6900.
The volunteers at SHIBA go through regular training to stay on top of all the newest ins-and-outs of the government sponsored plans. One-on-one counseling is available to answer any questions you might have about what’s available in our area.
Senior Healthcare Options – 360-828-5544.
Senior Healthcare Options have advisors who can help you in choosing a Medicare plan and assist you with the application process.
Washington Health Plan Finder can be accessed using https://www.wahealthplanfinder.org, or by calling 855-WAFINDER (855-923-4633).
I’m trying to obtain my medical records from a doctor who is no longer in practice. How do I go about this?
Physicians are required to hold medical records for people 18 years of age and older for seven (7) years after the patient’s last visit. Medical records for people under 18 years of age are held a bit longer.
If the doctor was a part of a group practice, please call the group practice administrator. Again, if the records date back more than seven years, they may have been destroyed.
If the doctor was a solo practitioner, try calling local physicians in the same specialty; sometimes, retiring physicians will give the records their colleagues to assist in the transition.
If the physician has gone out of business recently, i.e., within the last 1-2 years, please check their website for instructions. You may also call the practice phone to check for recorded instructions.
I had no idea it would be so difficult to get into a doctor’s office. I don’t understand why insurance companies have to make things difficult. I didn’t know anything about reimbursements and why doctors’ offices are closed to taking me – why doesn’t someone do something about this? How can we get things changed?
The practice of medicine continues to evolve in ways that present challenges for both patients and physicians. The astounding advances in technology, medications, and surgical techniques come with very high costs. Our nation’s economy has struggled since the 2008 recession. Our state and federal governments cannot afford to keep pace with the continually rising costs of health care, and in fact have been lowering reimbursement rates slowly but surely for over ten years now. Physicians have few choices; they can limit access, shorten appointments, or close their doors when expenses outpace revenue.
Our state and federal legislators are the ones who need to hear from you. Elected officials listen to the people who vote them into office. You have the power to influence them to advocate for accessible health care. Contact information for our state and federal legislators is provided below.
Contact information for our state and federal legislators is provided below.
Washington State Legislators Toll-Free Legislative Hotline: 1-800-562-6000 To find out who represents you, go to www.leg.wa.gov