Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
Note that this can also come up in non-emergency situations. For example (one we encountered): surgery with an in-network physician but the anesthesiologist is out-of-network. Patient should be advised of this in advance, but it's really on you to clarify/verify. In our case, the surgeon had strong opinions about the quality of the anesthesiologist and indicated that he would be unhappy if we insisted on a different, in-network person. Rock/hard-place.
Sounds like the doc and anaethesiologist have a little scam going.
I would suggest that before getting all worked up over this, check to see if your state has regulations prohibiting out of network charges for emergency services rendered through an in-network hospital. Way too many consumers allow themselves to be ripped off because they never took the time to learn the most basic about their protections.
Six states outright prohibit emergency rooms to charge out of network charges when a person is brought in.
Fifteen other states that has regulations that requires in-network billing for in-network emergency room care by out of network providers within an emergency room.
So, are you in one of those states? If so, use the regulations to fix it!
So, come one, tell us---what are those six states? Feels like a Jeopardy Show
Sounds like the doc and anaethesiologist have a little scam going.
I understand your point, but really did not have that impression. A delicate surgery on a child? You want your surgeon to be 110% comfortable with the anesthesiologist. At least we did.
I have a couple of experiences like this. Go to out of network ER, once stabilized I informed them to transfer me to an in network facility, was told I was too critical and they would accept as in network. Later received huge bills, no one remembers my demand to be transferred. I refused to pay and told them to sue me. Bills were set
First, you need to know that even if you go to an in-network hospital not all providers at the hospital will be in-network with your insurance. There are certain groups of providers that intentionally choose not to contract so they can balance you bill you
Alternatively, they intentionally choose not to contract with insurance because it is too expensive to play their games.
The hospital is a facility. Facility fees are in-network. The providers are separate. I am a surgical sub-specialist that works IN the hospital but not FOR the hospital. I am not in-network with any insurance. I used to be but they made it too difficult to play the insurance games. They don't pay their bills. This would not be an issue if insurance companies would make an offer that providers want to sign up for.
As of Jan 2018, add Oregon to the list of states that will have trouble finding ER specialists to take call and work for free. Way to shoot yourself in the foot Oregon.
Last edited by toofache32; 11-03-2017 at 06:47 PM..
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
