<p>Just wanted to say I spoke to an anesthesiologist in the town and he said most doctors will have nothing to do with the exchange. The reimbursement rates are like 20 cents on the dollar, essentially unaffordable to them. I suspect the doctors who will sign up will not be the doctors you want to see if you get sick. Calmom, even Blue Shield said the network for the exchange/off-exchange will be around 50% of the current PPO network. I will bet you that number is too high. </p>
<p>As you said, hopefully, I will not need extensive care until I am are eligible for Medicare. As I said in my previous posts, it is a great system until you need medical care and then we will see how it works.</p>
<p>This was posted last week, has anyone in CA checked the providers today?</p>
<p>Covered California announced that it will be loading onto its website an easy-to-use provider directory this weekend with availability on Monday, October 7, 2013. By loading it during a non-peak traffic period, we are confident that it will not negatively affect system performance for consumers. The system will not have to go down in order to load this information, and again, performance is not expected to be affected by this activity. In the meantime, please communicate to consumers that they can find provider information by going to the Covered California individual health plan websites. All of our plans have online directories and no registration is required to search for a provider.</p>
<p>To me that is not a deadline issue, it’s inept programming at the outset. A site template is the first thing you create, not something added on after you’ve programmed the underlying database. So the layout should have been coded and tested on all browsers ages ago.</p>
<p>The other parts of the Covered Cal site are very nicely done, so it looks like they let the database programmers also take care of the design interface, which is dumb.</p>
<p>Somemom, I’m trying to access the Covered Cal portal right now and its running slower than molasses. I’ll let you know but I’'m not optimistic. </p>
<p>Goldenpooch, I have a hard time believing that there is an anesthesiologist in your community who is planning on screening patient’s health insurance when he’s called into surgery. Either the facility where the anesthesia is needed will take the patient or not. </p>
<p>The networks will have enough providers to meet the needs of the number of insureds. If a greater number than expected people sign up, they will probably expand the networks as needed. But in communities where there are a lot of options to choose from, the insurers are going to hold down costs by signing on the providers who offer the most competitive rates.</p>
<p>I agree that’s an ugly-looking error. But, meh. These interface errors will be fixed. I’m more concerned about substantive problems, like the cliff at 400% of FPL and the millions of people who won’t get Medicaid and are ineligible for subsidies. (As I think you are too.)</p>
<p>CF, there are things that are easy fixes and things that are hard fixes. I tend to get a lot more annoyed when the easy stuff is messed up. I don’t like to see incompetence, I don’t like knowing that $$$$ in taxpayer money has been spent on a contract to inept designers. Maybe the sloppy HTML provides a clue as to other issues as well – it’s a lot easier to code HTML than to write the backend code for the database. </p>
<p>I’m not worried long term about the signup – I just thing that they are creating more confusion than needed. If they weren’t ready for rollout, maybe they should have gone with a more simple interface to allow people to set up basic accounts and then get callbacks or email responses from agents, until the rest was ready to go.</p>
<p>I spoke with a Blue rep in AZ regarding travel outside the state as well as network inside the state for in & outside the exchange plans, he said:</p>
<p>“We will still have the AZ statewide ppo, two performance network and bluecard will still be available when traveling outside of Arizona.”</p>
<p>Thus far, the word I get in two states is that they are trying to have the same networks, it remains to be seen how the negotiations go. I am waiting at least another month before signing up, maybe late November, I have told my clients the same. There is no reason to do the work twice, once more is determined and this rush is over, we can make a more informed selection of plans.</p>
<p>Update for Somemom: I think they’ve botched the database uploads – I’m seeing what looks like mismatched data on a lot of entries – the type of stuff you see if you try to upload a CSV file to Excel and there’s a stray comma somewhere, so you end up with data gong into the wrong fields.</p>
<p>I am so hoping that one (at least) of the exchange plans is a PPO in Arizona. My kid’s doctor says they are providers on all PPO plans, but not on HMO, EPO plans.</p>
<p>No question that fixing the bug where the final screen doesn’t display right in Chrome is an easy fix. But finding all such trivial bugs before release, on all browsers, is far from easy. When I was working, I wrote software for a living, my husband still writes software for a living, and I live in Silicon Valley where lots of my friends write software for a living. I don’t write software for a living any more because I don’t work for pay, but I still write software just for fun. Bugs happen. So I can’t get exercised about trivial bugs. </p>
<p>Yes, it would be better if they had been found before the release, yes, it would have been better if they had had more user testing before release, yes, the bugs must be fixed, but browser incompatibility is not exactly unknown in other software. This is not the only piece of released software that doesn’t work correctly with Chrome.</p>
<p>They should not have tried uploading the provider database for the first time while keeping the software live. They didn’t want to go offline, but they should have.</p>
<p>“The website and enrollment problems don’t “matter so much in October, but for the actual enrollment campaign, this all needs to get fixed by November or they won’t be able to process the volume they’re going to get,” said Jon Kingsdale, an exchange expert who helped set up a similar marketplace in Massachusetts in 2005 and who now works as a consultant for several state-run exchanges.”</p>
<p>I believe the government outsourced the site design and implementation to private industry. I don’t know anything about programming or web design so I hate to criticize, but it does seem like they could have done a better job than they did.</p>
<p>“The networks will have enough providers to meet the needs of the number of insureds. If a greater number than expected people sign up, they will probably expand the networks as needed. But in communities where there are a lot of options to choose from, the insurers are going to hold down costs by signing on the providers who offer the most competitive rates.”</p>
<p>Calmom, what is your source for this statement? Do you have some factual basis to assert the above or it is speculation? Also, it doesn’t address the other problem of having the most competent doctors not participating in these exchanges.</p>
<p>BTW, when you have elective surgery, you must arrange for the anesthesiologist beforehand. It is up to the patient to see whether they are included in the network.</p>
<p>Edit: If you’re right and they increase the number of providers, it will probably mean higher premiums for the unsubsidized. My 100% increase in the premium will probably be the first of many increases under this law.</p>
<p>I saw a family today, with a $9000.00 (!!! holy cow!!!) deductible and a 20 mental health visits per year limit, and they could not find a spanish speaking therapist. This teen had just been discharged from an inpatient hospitalization. I sure hope their’s is a viable plan. (OTOH, that inpatient stay might have met much of the deductible.)</p>
<p>calmom, do I understand correctly that the database uploads you are talking about (that were botched) are new databases of providers, being uploaded today?</p>
Common sense. The insurers are running a business. They want customers. They want profits. They also want to keep premiums affordable by holding down costs, because that helps them get more customers. It’s basic economics.</p>
![http://obamacareguide.files.■■■■■■■■■■■■■/2013/10/covered-ca-image.jpg[/url]](http://obamacareguide.files.wordpress.com/2013/10/covered-ca-image.jpg%5B/url%5D){kind=link}
![http://obamacareguide.files.■■■■■■■■■■■■■/2013/10/covered-ca-107.jpg[/url]](http://obamacareguide.files.wordpress.com/2013/10/covered-ca-107.jpg%5B/url%5D){kind=link}
