Some physicians and other healthcare providers are experiencing new challenges associated with enrollees of the new health plans sold on the Obamacare insurance exchanges. Management groups working with providers are offering suggestions on how to be prepared, as HHS expects another enrollment surge ahead of the March 31 open enrollment deadline.
One of the key issues is misunderstanding about enrollment versus actually being covered. It's confusing for both patients and providers, experts say.
“Just because a patient is enrolled doesn't mean they are covered,” said Anders Gilberg, senior vice president of government affairs for the Englewood, Colo.-based Medical Group Management Association. For example, patients who paid their premium and were enrolled on Feb. 20 would not be covered until April 1, he said. So when new patients walk into a doctor's office saying they are “enrolled,” the physician still may need to confirm the effective date of the patient's coverage.