A practice may opt to leave an insurance network for a number of reasons. It is helpful to notify patients/families who are covered by that insurance company about this change as soon as feasible, so that they have time to plan.
Patients/families need to be informed of the date that the practice will no longer be accepting their health insurance, and the fact that they may want to identify another medical home that accepts their insurance. Alternatively, the patient/family could pay out-of-pocket for care, switch insurance products during their next open enrollment period, or talk to their employer's benefits manager.
Additional suggestions for the practice include:
- Offer to meet with affected patients and families – either individually or, if there is enough demand, in a group setting to answer any questions and/or concerns they may have.
- Develop a list of referrals for other pediatricians who participate in the insurance plan to share with families who are interested in staying within their current network.
- Waive the fee for providing patients with copies of their medical records; offer to provide them in whatever manner is most convenient for the families (eg, mail them directly to their new pediatrician) at no additional cost.