California requires more accurate directories

Some patients have difficulty ascertaining whether a specific doctor accepts a specific insurance plan. Often times, the insurance company will provide a directory listing doctors who take a specific plan, but they will include a disclaimer for patients to check with the doctors' offices before choosing. Likewise, a doctor's office might say that that the doctor accepts a specific plan, but will also often include a disclaimer to check with the insurance company. Neither side wants to accept final responsibility for the designation (the doctor wants to be paid in full even if the insurance company claims that the doctor is out-of-network, and the insurance company does not want to be on the hook for more than it has to if it turns out that the doctor does not actually accept a specific plan). Unfortunately, the patient is caught in the middle, with the two parties who would best know disclaiming responsibility. How can the patient actually find out? The patient can undergo the procedure, and see how the bills come back.

In theory, this should not be that difficult of a problem for insurance companies -- they have a list of doctors who have signed legally binding contracts with them, agreeing to perform specific procedures for specific prices. Up until recently, however, insurance companies probably have not had a strong incentive to care about the accuracy of their directories. California is reported to have recently enacted legislation to counteract this: insurers must provide an accurate directory, and if they list a doctor as in-network and the doctor is actually out-of-network, the insurance company must cover the difference in patient responsibility (hence, the patient would only pay the in-network price). In theory, the patient can now go to one single place to determine whether a specific doctor in California accepts a specific plan.