AJ asked in Business & FinanceInsurance · 2 months ago

Provider reviews of health insurance?

Is there any way to get opinions from doctors and other care providers about different health insurance companies?

I have a family member with a semi-rare medical condition, and he frequently needs services/drugs that require 'prior authorization' from the insurance company to be covered.  When this process (inevitably) gets screwed up, he suffers.

Medical providers, and people who work in their offices, are in the best place to know which companies have their act together.  Sure, problems happen with every plan, but if doctors DREAD dealing with one particular insurer because there's CONSTANTLY an issue, I'd like to know.

Is this out there somewhere?

Update:

I only brought up the medical condition to show that prior auth is going to be a recurring issue. I have LOTS of other criteria to choose a plan.

Doctors generally won't bad-mouth a specific insurance plan to a patient, and discourage their staff from same.  It's considered unprofessional.

Still, if there's something like anonymous reviews for the Provider/Insurance-Auth relationship, I'd like to read them.  Sometimes the top two or three plans on my list are very close in price, after all.

4 Answers

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  • 2 months ago

    It would be best (as someone else said) for your family member to ask their provider, since they're the ones that typically deal with that condition.  Otherwise, generic reviews from providers are just going to tell you which insurance companies reimburse them the least.  I would always hear, "Oh, my brother-in-law told me not to go with XYZ Insurance, because they're not good."  "Is your brother-in-law a doctor?" "Yes, how did you know that?"  "Because your brother-in-law gets paid the least from that carriers, so he's bitter about it.  Otherwise, they're a good company."

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  • 2 months ago

    Insurance has a contract with the doctors.

    If the doctor has a contract with the doctor, you can surmise that the issues they have with the insurance company do not outweigh the access to in-network patients or the associated income.

    If there are specific issues that you don't want to deal with, with insurance look for insurance policies that don't have that issue.

    - all insurance will require some "prior authorization"

    - HMOs and medicare advantage plans would require this more since it's part of the business model.  Look for PPO plans or if on medicare a Medicare Plan F, G, etc

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  • Judy
    Lv 7
    2 months ago

    you could ask his docs or their office managers, or google the company names of the insurances he's considering.

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  • Lili
    Lv 7
    2 months ago

    Given that you have a family member with a particular condition and these authorization issues, don't you think that talking to his specific doctors about their views of the insurance options would be best? And don't you think you're more likely to get information on whether there's some sort of reliable website you can look at from medical professionals themselves -- such as your relatives' physicians?

    I have to warn you that most often doctors don't deal directly with the insurance companies anyway and aren't the best people to consult. They have staff who handle these things. They'll get involved if they really feel the need to argue an insurer's decision, but usually it's staff interacting with the insurers. 

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