California News

Covered California pulls error-plagued doctor directory from website

Friday, February 07, 2014

For a second time, the Covered California health insurance exchange has pulled the error-plagued doctors directory. Consumers have been frustrated to learn doctors listed as part of their plan will not see them.

Covered California says the lists are provided by insurance companies. Some patients who depended on these lists when they signed up for coverage are now discovering they can't find doctors in their plans.

"I was so happy that starting January I was going to get the coverage, but it was a nightmare and it's been a nightmare since then," said Downey resident Maria Berumen.

Berumen says after getting health insurance, finding specialists has been difficult. She says online her plan shows a long list of doctors, but it isn't very accurate.

"When you call the doctors, they're retired," said Berumen. "When you call the doctor's phone number that's there, it's not listed -- it's a wrong number."

Covered California admits it found similar problems on its own lists of doctors.

"Covered California has been able to determine that some of that information is not accurate and so for the consumer's benefit we are taking that information down. We're taking the directory down," said Dana Howard, spokesman for Covered California.

But it's difficult for people who already have health insurance, like Berumen. She says four doctors refused to see her even though they are on the list, and she's had trouble finding a specialist in her plan.

"I live in Downey. The neurosurgeon they sent me to, I had to drive all the way to Fountain Valley," said Berumen.

"Each time we send a patient to any of those doctors, the doctor says, 'No, we are not contracted with this plan," said Dr. Ragaa Iskarous, a family practitioner.

Iskarous says it's been very frustrating trying to figure out where to send her patients.

"Nobody gave us instruction or guidance, like which way to go to start with," said Iskarous.

Covered California says it can't keep up with changing lists of thousands of doctors. T hey say consumers need to call their insurance companies to find out which doctors are in their plan.

"Sometimes the doctors are simply not aware of the contracts that they have signed with the insurance companies, aren't aware that yes, they indeed are obliged to accept insurance plans through Covered California," said Howard.

If you can't find a doctor that works for you, you can cancel your existing plan and sign up with a new plan. Open enrollment for Covered California plans ends on March 15.

(Copyright ©2014 KABC-TV/DT. All Rights Reserved.)

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health, health care, health insurance, california news, carlos granda
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