allaneparker
New member
A family member of mine has insurance, but for many reasons does not see an in-network doctor. The plan has limited coverage for out-of-network doctors. She’s been seeing her primary for many years now, and the doctor recently moved to a different group practice. My family member transferred all her patient records and everything, but when she went to set up an appointment they refused to even schedule her because they didn’t accept her insurance. She explained that she’s willing to self pay if needed, but she’s almost out of her medications so she really needs to see the doctor. They told her that it would be insurance fraud to let her self-pay. How is it insurance fraud to have the patient pay for it if no claim is submitted to the insurance? And is a doctor’s office allowed to refuse a patient for being self-pay?