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Re: AetnaFrom: ATB28@aol.comMon Nov 27 17:46:09 2000
Deborah: It is possible. It can happen when you are caring for a patient in an HMO product who's PCP is in an IPA/PMG. In such arrangements, the "network" = the IPA/PMG's network, not necessarily the health plan's network - which is usually larger. In other words, the health plan may have a contract with a particular hospital but if the IPA or Medical Group doesn't, and they are the ones that will be paying for your services (not the health plan) you'll be restricted to the hospital of the IPA/PMG. That's the way it works in California. Allan In a message dated Mon, 27 Nov 2000 7:21:21 PM Eastern Standard Time, "Deborah J. Wage" <wagedj@bellsouth.net> writes: << Aetna told my billing coordinator today that when a provider is 'out of network' the hospital that he or she delivers at is automatically considered 'out of network' even if the hospital has a contract with Aetna making them '*IN* network. I find this unbelievable and have never heard of such a thing with any other insurance company. Anyone else? Deborah Wage, MSN, FNP,CNM
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