Patient abandonment timeframe in California?

[St. Margaret]

Does anyone know at what point an OB practice cannot "fire" you as a patient before your birth? I'm in California. I really want to stop going to my shadow care appts at this point (my next one is actually not til Nov, I lucked out under the radar on that one ) and if there's a certain timeframe, that would make it very easy. Otherwise I'll need to navigate what the insurance would make of things if I stopped going, but then needed a transfer. I'm very done! I really feel the need to be visualizing the birth I'm planning to have this time, instead of this odd double reality of both sets of care providers. Any know the law?

[mwherbs]

So if you needed to transfer would you want this doc to attend you? If you want to maintain the relationship to that potential end then make up some sort of holiday vacation trip story to put off visits... Otherwise just forget it, stop going.

[msmiranda]

Just off the top of my head and not based on any research, my understanding was that it's a medical ethics rule and I think they have to give you 30 days to find a new provider. I don't know whether it's the *law*, but I know you can file a complaint to the state board or whatever if someone drops you less than 30 days out. With pregnancy, I guess that means 36 weeks? Though if you went into labor at 38 weeks then you would not have had 30 days ...

I am in this quandary too (or will be in several months) and I do remember during my last pregnancy that seeing shadow care docs got too stressful. I think 34 weeks was my last appt with them ... and do you know they didn't call until MONTHS after the baby was born? (like two months, I think) And it was the billing lady who was calling me because she was trying to settle the account. So much for caring about the well-being of patients, lol.

[St. Margaret]

that's hilarious the care providers never actually checked on you.

I didn't mention, this is the only OB/CNM practice that is in my medical group. So I guess that might mean they are not allowed to discontinue care anyway, because they are the only ones the insurance will allow, they are contracted with the group... or it might mean that then the insurance would let me see whomever. I just want to be sure that the insurance pays in the event of a transfer. I don't particularly care if I see these guys, although I guess I like the CNM okay-- but I figure if I transfer, there'll be something more going on anyway... the one OB I've met a few times seems okay but I know him to be a total UAV, from a friend's traumatic birth. This is really just to cover my butt financially from here on out

Hmm I'll be 37 weeks by the time of my next appt (WHOA!), so maybe I'll just cancel that a little before with some excuse, saying I'll figure out when I can resched and call back... and just not. If I can fly under the radar, so much the better. If they call me, I'll just say I'm doing fine Or screen my calls as I tend to do anyway

[karen1968]

Does your insurance require OB/CNM prenatal care to cover a hospital birth?? I have not been doing shadow care at all, just knowing my insurance covers hospital births...it never occured to me that prenatal care with a covered provider would be a requirement. Can you call your insurance to find out?

I *did* just transfer care to a hospital-based CNM group due to previa. They remarked that I'd been getting excellent prenatal care. I brought a copy of my records. Maybe you can just make sure to have an updated copy of your records in case of emergency?

[LemonPie]

My DH is a family practitioner in CA and he says 30 days. The patient must be notified that they are 'fired' and need to transfer care by certified letter. During the next 30 days, the physician doing the 'firing' is required to see them for emergency situations only.

[St. Margaret]

Thanks, LemonPie! If I cancel my appt a few days beforehand, by the time they could even figure out I wasn't coming in, and fired me, I'd be safe, then.

Karen, I'm not SURE what the situation is with the insurance, but my physical therapist (who works for the outpatient PT center of the insurance group!) was billed for her birth because of the slightest little thing, and I would much rather NOT spend hours on the phone and writing letters and such (which she had to do, to get it paid). I've been through that ringamarole way too many times. I'm thinking it's likely that it won't matter either way, that they have to take me at the hospital if I show up, but I figured it was worth checking to see what was likely the case about getting fired, just to ease my mind