Can a doctor refuse to treat you if you have two different insurance carriers?

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Can a doctor refuse to treat you if you have two different insurance carriers?

My father has a primary care doctor he’s been seeing for about a year who
recently refused to see him on the day of his scheduled appointment. The
reason given was that my father has a new insurance carrier I don’t recall which
one but that his carrier from last year Humana shows him as still being
enrolled in Humana. My parents are struggling to get through to Humana on the
phone to resolve this, but I’m uncertain as to why the doctor can’t just bill the
new carrier regardless. Is it even legal for the doctor to refuse care to someone
with a valid insurance policy just because their old policy also shows as being
active?

Asked on January 8, 2019 under Insurance Law, Tennessee

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 2 years ago | Contributor

This is legal:
1) As a general rule, doctors are not forced to take or keep patients, or to provide care, if they don't want to--doctors are not public servants, they are essentially each their own business, and just like a given accountant or plumber could refuse a job or a customer, so can a doctor.
2) If the doctor isn't set up to take or doesn't have a contract with the new insurer, they might be paid less, might have to spend more staff time (i.e. money) to get paid, or might have difficulty getting paid at all. The doctor is not required to take on those risks or costs.


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