Why is Thrive Gynecology out of network with insurances?
Many of the frustrations that many patients have experienced with OB/Gyn care are due at least in part to the medical insurance system, which offers such poor reimbursement for women’s health that doctors must see large numbers of patients per day, leading to long wait times and short appointments. Gynecologists who are in-network with insurance plans are in a constant battle to get their patients the care they need: spending hours on the phone to obtain approvals for necessary procedures and surgeries, disputing denials, and sometimes having entire surgeries unpaid by insurance plans after they were approved and performed, with no recourse. In-network practices must also employ staff whose role is simply to spend hours on the phone with insurances to obtain authorizations and fight claim denials.
This is particularly the case for complex gynecologic surgery, especially endometriosis surgery - where insurance companies will reimburse a 4 hour surgery with extensive and careful excision of endometriosis, lysis of adhesions, removal of ovarian cysts and preservation of fertility, the same as an ablation where the surgeon simply cauterizes one spot. Insurance companies also value complex gynecologic surgery at a fraction (sometimes an order of magnitude) that of procedures in other surgical fields such as orthopedic surgery or urology, even if they take significantly less time. Also, since many patients have high deductible plans, they are often already paying out of pocket for much of their care, even if they have insurance.
These are the reasons that virtually all private practice minimally invasive gynecologic surgeons with a specialty in endometriosis are out of network with insurances. The fact that this is not the case with other surgical specialties is a reflection of how women’s health is viewed and valued by the insurance system.  Dr. Tang does want to ensure that as many patients as possible can be seen, so please speak with our office specialists to discuss pricing and payment plans with CareCredit.