SHELBY CO., Tenn. - A Shelby County family officially filed a complaint against an insurance company after finding limited doctors in the county.
Enough of a headache for them, the Iley Family file a complaint with the state’s Department of Commerce & Insurance last Wednesday, a day after FOX13 first reported on the issues they have been having.
Some relief might be on the way.
The Ileys sent the station an email that they got from a grievance and appeals liaison for Ambetter.
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That email showed a list of eight OBGYN and gastrointestinal doctors in network and in Memphis.
Those doctors are from two separate practices.
FOX13 confirmed separately that those doctors do, in fact, accept Ambetter.
The insurance company also took off at least one OBGYN doctor from their website that FOX13 reported did not accept the insurance.
But FOX13 also found multiple doctors listed as practicing from Methodist Le Bonheur as accepting that insurance.
Two spokespersons for the hospital said that the hospital does not currently accept Ambetter.
But a spokesperson for Le Bonheur added that hospital is working to accept insurance in Tennessee.
Sarah Farley, spokesperson for Methodist Healthcare, emailed FOX13 on Tuesday, adding that it reached out to Ambetter to update “incorrect Methodist Healthcare information on their website.”
Farley provided FOX13 the following statement:
“We have been made aware that Ambetter has incorrect Methodist Healthcare information listed on their website, and we are in contact with them to ask that they update their Methodist listings to ensure accuracy. Methodist hospitals are not designated Ambetter providers. The Methodist outpatient retail pharmacies currently accept Ambetter insurance as part of a larger pharmacy benefit agreement that facilitates coverage for third-party pharmacy payors. A portion of our physician practices, predominantly in Mississippi, also accept Ambetter. Where allowed by law, we do our best to share with patients up front if their coverage is out of network and redirect their care to an in-network provider.”
A Le Bonheur spokesperson said he is still looking into the list FOX13 sent.
Editor’s note: Our report initially did not identify a hospital as looking at accepting Ambetter insurance or differentiate between Methodist and Le Bonheur.
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