Help Patients Fight Narrow Networks
Is a health plan’s network large enough to cover all physician specialties needed for all the members in the plan? Patient complaints about health plans’ networks have become more prominent in the past couple of years. Some criticisms include problems locating a specialist who is accepting new patients, finding a physician within reasonable driving distance from the patient’s home, or inaccurate information in the health plan’s provider directory.
What can a patient do? The Texas Medical Association (TMA) has created a draft Texas Department of Insurance (TDI) complaint letter you can give to your patients, or go a step further and help customize for your patients. It is available in both English and Spanish.
Also, if your office is having a difficult time finding a specialist needed for medically necessary care in a health insurance product directory, you also can file a network complaint to TDI.
TMA Draft Complaint Letter(s)
TDI Complaint Form(s)