Sara Rothstein

Health policy. Brooklyn. 🌈. COVID Long hauler. Will travel for carbs.

[Sara Rothstein @_SaraRothstein]

Hey @AnthemBCBS and @Accredo - I’m having major problems getting my Rx covered. Each of you says the other are supposed to cover it. I’ve spent 2 weeks and many hours in the phone trying to resolve this without success. Can you help?

[Sara Rothstein @_SaraRothstein]

@khemp64 It depends on which networks are being used and how the deal is structured

[Sara Rothstein @_SaraRothstein]

@N_Brennan Congratulations!

[Sara Rothstein @_SaraRothstein]

Cool cool. My health insurance company is experiencing a “tech glitch” and every single doctor in NY is coming up as out of network. Literally every single doctor.

[Sara Rothstein @_SaraRothstein]

@ahandvanish Star Spinner Tarot Cards By Trung Lê Capecchi-Nguyễn. I got them as a gift and tarot isn’t my thing so I’m not an expert, but they were quite aesthetically beautiful

[Sara Rothstein @_SaraRothstein]

@onceuponA Is the question whether MCOs get a pmpm for non-utilizers? At least in MA, and prob elsewhere, yes, MCOs/ACOs get a pmpm from MassHealth based on rating category

[Sara Rothstein @_SaraRothstein]

@nikillinit There are far fewer billing codes for dental care than for medical care. Also, far fewer insurers and a lot less variation in what’s covered insurer to insurer.

[Sara Rothstein @_SaraRothstein]

@JoshGoodman_BU @rothstein_jesse @JetBlue Yup, it’s thunderstorm season on the east coast. On good weather days, things are more or less fine enough, but even a short intense storm can wreak havoc. Safe travels!

[Sara Rothstein @_SaraRothstein]

@nikillinit Sort of, but there isn’t the disruption one would expect for the level of frustration . . .

[Sara Rothstein @_SaraRothstein]

@NYHammond Yes! Thank you!!

[Sara Rothstein @_SaraRothstein]

Can someone remind me where I can find the chart that shows healthcare costs rising faster than costs in other industries? I can’t remember who publishes this chart

[Sara Rothstein @_SaraRothstein]

@DaniaPal I’m so sorry. I hope you recovery quickly!

[Sara Rothstein @_SaraRothstein]

@dp_oneill @costplusdrugs It would be interesting to explore the fiduciary duties of ERISA plans that permit this kind of billing.

[Sara Rothstein @_SaraRothstein]

@mayakauf @ZachWritesStuff https://t.co/erF7po5zDs

[Sara Rothstein @_SaraRothstein]

@alexanderchee Wait, the series will end? This series has been an amazing addition to my life. I’d be so sad if it ends.

[Sara Rothstein @_SaraRothstein]

@DaniaPal That’s my guess too, but the lack of info is really something.

[Sara Rothstein @_SaraRothstein]

I tried to get info & came up short. wanted to know if the Customer network had a separate MOOP from other network providers. In the member portal, the SPD was outdated and didn’t mention this network and I couldn’t find the SBC. There was also no list of preferred providers.

[Louise Norris @LouiseNorris]

@SheronESidbury @kgmom219 @_SaraRothstein @consultbenefits I haven't seen that terminology before either. I have the same questions as Jenny, and would love to see more details about this plan.

[Sara Rothstein @_SaraRothstein]

@DaniaPal It’s a large university, which includes an affiliated health system

[Sara Rothstein @_SaraRothstein]

@SabrinaCorlette Could be, but there was no info on who was in which tier. I spent 20 minutes in the member portal and found zero information. And I’ve never seen separate MOOPs for different tiers in a network.

[Sara Rothstein @_SaraRothstein]

Insurance people: I know what In Network and Out of Network are. What the heck is this third category “customer network”? If it matters, this is a United plan through an employer (not mine).

[Sara Rothstein @_SaraRothstein]

@consultbenefits @LouiseNorris