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Advice about HealthNet
Hi, I am wondering if anybody has any recent pregnancy and childbirth experiences with Health Net HMO. The experiences I found on this forum are quite old. This is my first pregnancy and I recently switched to Health Net HMO. My friends and other people tell me horrible stories of HMOs - they cut corners in order to cut costs, they would deny claims based on random things etc. etc. I am worried sick and am just looking to hear about some recent experiences you've had with Healthnet HMO with pregnancy and childbirth and who was your doctor btw? Worried first-timer
Feel free to email me if you have further questions. Kim
The one thing I will say is that we had some squabbles between HealthNet and our medical group (Hill Physicians) about which one of them would pay for something -- the infant hearing screening done in the hospital and the pediatrician visits while in the hospital (our son's doctor didn't have privileges at Alta Bates, so he saw the in-house pediatrician). It's not that Healthnet wouldn't cover them, it's just that the two sides had to fight about it. That was kind of a pain, but I haven't heard anything more about it in a few months, so (knock wood) it seems like it's all resolved.
So, on the whole, I'd recommend HealthNet HMO for pregnancy and childbirth. My OB was Lonnie Lin, with OB- GYN Partners for Health. I liked her a lot -- though Jennifer Yarger in her practice was actually the one who delivered my son. I liked Dr. Yarger too! HealthNet mom
The customer care team at Hill Physicians would like to help. Please contact us at Customer.Care@hpmg.com so we can address any concerns you may have. Thank you, and congratulations on the recent addition to your family.
Hill Physicians Customer Service
I am expecting my first child in early April, and have recently started the hunt for a pediatrician. I am a professor here at UCB and have been using Health Net as my health care provider since 1993. I also, ironically, grew up in Berkeley, and thus my first choice of a pediatrics group was the one my mother chose for me: Berkeley Pediatrics. My second choice was East Bay Pediatrics, which has also come highly recommended from multiple sources. Thus, you can imagine my great dismay when I called each of these groups and learned that they are not accepting new HMO patients. At the present time, in fact, there are only 3 pediatricians (none of whom have group practices) that are accepting new HMO patients in Berkeley.
Apparently a dispute is occurring between the HMO's and pediatricians in particular. The dispute seems to involve, unsurprisingly, the lack of satisfactory payment to doctors for treating HMO patients. Negotiations are ongoing, but no one is willing to predict the outcome of this sad state of affairs.
I am writing to let those of you who will be looking for a pediatrician know that this situation exists, and to urge any of you who belong to HMO's to voice your concern about this situation. My OB-GYN believes that pediatricians are being very poorly treated by the HMO's and that this situation may escalate and even affect existing patients. Perhaps added pressure from HMO patients (I suppose they call us "customers") will provide additional incentives to settle this matter and provide the level of choice that the HMO's had previously promised. I will not hesitate to quit Health Net and pay more and join a PPO in order to be able to use the pediatrician of my choice. Of course, this will involve the inevitable HMO-type hassles, such as the open enrollment window (Nov. for UC employees) being closed.
If anyone has any more information than this small amount I have gathered, or any sage advice, I would be most grateful! Jenny
UC Bencom web page: http://www.ucop.edu/bencom
UC Bencom Customer Service: 1-800-888-8267 (9-4 M-F)
The above web page also lists phone numbers for all the medical plans at: http://www.ucop.edu/bencom/info/hw.html
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