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Jim

Tina

Tom

Michelle

Jim, Tina, Tom or Michelle ColoradoHealth.com 8751 E. Hampden Ave, #A-1, Denver, C0 80231 303-782-0123, 303-782-0804(Fax), email=Michelle@Coloradohealth.com

Matching a doctor with your health plan can be important. Here’s a few tips.

1) Most Kaiser doctors only see Kaiser patients. If you choose Kaiser you will be working in their system, although they will refer out to specialist and places like Childrens Hospital when needed.
2) HMOs, PPOs and doctor networks: A lot of confusion surrounds this area. If you are going to join an HMO and want a specific doctor, make sure your doctor is in that HMO group. Some HMOs have “pods” in the network in which they refer to. You’ll need to select a Primary Care Physician (PCP) for most HMO networks. Each person can have their own PCP. PCPs are generally doctors associated with Family Practice, Internal Medicine, or Pediatrics. Most women can go directly to their OBGYN without a referral from a PCP (as long as the OBGYN is in the HMO network.) PPOs (Preferred Provider Organizations) typically have more doctors in them and you will not need a Primary Care Physician as you will generally be able to go to a specialist directly. (United Healthcare also lets their HMO people go to any doctor in the network without a referral.) Most PPOs have out of network coverage which allows you to go to ANY doctor but it will cost you extra.
3) Indemnity plans are relatively rare as they tend to be expensive, but they allow you to go to any doctor. The problem is that the carrier will not get any discounts on the charges, and you may end up paying a good part of the bill that is considered above usual and customary rates.
4) Doctor Networks: Sloans Lake and PHCS are examples of doctor networks. Different carriers such as Golden Rule or Pacific-Life can “rent” these networks for their use and benefit from the negotiated discounts.

I really like www.Medicalquest.com for finding all the different plans your doctor may be associated with. It’s not always 100% accurate, (call your doctor to make sure) but it’s a quick way to get pointed in the right direction. Go to their website and look under www.medicalquest.com Directories. Physician Directories and type in the name. The affiliations can be a little tricky like “HMO Colorado” is the HMO branch of “Anthem Blue Cross Blue Shield”. Just talk to us and we will help you out.