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Is Your Doctor Connected with the Right Hospital?

By Sara Fletcher posted 07-04-2013 01:48 AM

  

When it comes to receiving care from a hospital, you need to consider whether your doctor is connected to a hospital that is in your insurance network, specializes in the care you need, and is conveniently located in your area.

Your Doctor

Most primary care physicians are affiliated with one or more local hospitals. The depth and breadth of this affiliation may vary from doctor to doctor. Your physician may work at a certain hospital, as well as in their medical practice. Or, they may have a partnership agreement with a certain hospital – the doctor agrees to send their patients there, and in return, is able to continue providing comprehensive primary care during the patient’s hospitalization. 
  • The implication of this affiliation is: if you want your doctor to be with you when you go to the hospital, they essentially get to choose which hospital you go to. 
Your Hospitals

Depending on your location, there may be a number of hospitals to choose from, or only one or two. Rural areas generally have fewer options for hospitals, with significant distance between each one. Cities will have more – and those hospitals may specialize in treating certain conditions. One may be well-known for its cardiac care, another for having the best doctors in neurology, and another as primarily a children’s hospital. 
  • You need to be aware of what hospitals your doctor is affiliated with. In the event of an emergency, you or your family can inform paramedics which hospital you should go to. Your doctor may even be able to meet you there upon arrival – which can significantly reduce the stress of an emergency.
  • Keep in mind the location of your doctor’s preferred hospital. If it is located across the city from your home, it may not be the one you end up in should an emergency arise.
Your Insurance

The decision over which hospital to go to for care is determined by several factors beyond your primary care doctor’s preferences. A significant influence over your decision is wielded by your health insurance provider. Not all hospitals in your area may be part of your insurance’s network. If you receive care from an out-of-network hospital, you may be liable for a much larger portion of the hospital fees than you would at an in-network hospital. 

In order to receive comprehensive medical care that is fully covered by your insurance, you need to take action before you need emergency care, surgery, or other hospitalization. 
  • Check your insurance to determine which hospitals in your area are part of your network.
  • Research what each hospital in your area specializes in, paying special attention to conditions that currently or are likely to affect you in the future. You can find a lot of information from the US News best hospital rankings.
  • Ask your doctor which hospitals he or she is connected to.
In comparing the above three points, you may determine that a change in doctor or insurance network is necessary in order for you to receive the best possible care. Discuss the issue with your doctor, and continue looking into your options in order to find a solution that fits your needs.

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