bailadora
We create the dreams.
- Joined
- Oct 16, 2007
- Posts
- 3,855
I don't know if that's the right title to give this thread, but I'm going with it.
So here's the deal: in the last 8 months, I've had to use my insurance benefits more than I've had to in a very long time. And three times, despite my best efforts to avoid it, I've found myself in a situation where I was given care by a non network provider. These were not situations where I made a conscious decision to go out of network. In fact, I did everything I could to remind everyone of what insurance I had, so that I could avoid out of network charges. Didn't happen.
The first case involved me getting an out of network anesthesiologist when I had to have minor surgery in November.
The second case involved my tissue samples going to a non-network lab when I had to have my thyroid biopsied. I had made it a point to remind the receptionist of my insurance provider when the appointment was made. And right after the samples were taken, I inquired about the lab again, in the presence of the doctor. Cue crickets. He has a specific lab he prefers, and the samples had already been placed into their special vials, in their special solution. For reasons I don't quite understand, they could only go to that specific lab. Unless I wanted to lie back down and let him take five more samples. Since I was shaky on my pins from all the nervous dread I'd built up in my mind, I opted out of a second set of samples.
The third case involved tissue samples being sent to the lab at a nearby, in network hospital. But the pathologist who got my samples was, you guessed it, not an in-network provider.
In the first two cases, I was very lucky in that the billing offices agreed to work with me. Acknowledging that I wasn't given a choice to consciously accept or reject the in or out of network status prior to being given the care I received, they agreed to only bill me for what my in network costs would have been.
The last case not so much. Out of network is out of network, and instead of a $300 lab bill, I ended up with one for $900.00. Needless to say, I'm pissed off beyond measure.
It's one thing if I consciously make a choice see a non-network provider, but it's something altogether different to be given care and then informed of status after the fact. Especially when I feel like I've done everything I can to avoid exactly these types of situations. I absolutely LOATHE feeling like I've been backed into a corner and oh by the way, here's your enormous medical bill.
Given that we have Litsters from all different professions here, I'm wondering if anyone who works in medical billing, insurance billing, or hospital administration can share some tips on what the average Joe or Jane can do to avoid ending up in situations like this. It's a huge flaw in our medical system that often leaves people feeling like they got the short end of the stick.
So here's the deal: in the last 8 months, I've had to use my insurance benefits more than I've had to in a very long time. And three times, despite my best efforts to avoid it, I've found myself in a situation where I was given care by a non network provider. These were not situations where I made a conscious decision to go out of network. In fact, I did everything I could to remind everyone of what insurance I had, so that I could avoid out of network charges. Didn't happen.
The first case involved me getting an out of network anesthesiologist when I had to have minor surgery in November.
The second case involved my tissue samples going to a non-network lab when I had to have my thyroid biopsied. I had made it a point to remind the receptionist of my insurance provider when the appointment was made. And right after the samples were taken, I inquired about the lab again, in the presence of the doctor. Cue crickets. He has a specific lab he prefers, and the samples had already been placed into their special vials, in their special solution. For reasons I don't quite understand, they could only go to that specific lab. Unless I wanted to lie back down and let him take five more samples. Since I was shaky on my pins from all the nervous dread I'd built up in my mind, I opted out of a second set of samples.
The third case involved tissue samples being sent to the lab at a nearby, in network hospital. But the pathologist who got my samples was, you guessed it, not an in-network provider.
In the first two cases, I was very lucky in that the billing offices agreed to work with me. Acknowledging that I wasn't given a choice to consciously accept or reject the in or out of network status prior to being given the care I received, they agreed to only bill me for what my in network costs would have been.
The last case not so much. Out of network is out of network, and instead of a $300 lab bill, I ended up with one for $900.00. Needless to say, I'm pissed off beyond measure.
It's one thing if I consciously make a choice see a non-network provider, but it's something altogether different to be given care and then informed of status after the fact. Especially when I feel like I've done everything I can to avoid exactly these types of situations. I absolutely LOATHE feeling like I've been backed into a corner and oh by the way, here's your enormous medical bill.
Given that we have Litsters from all different professions here, I'm wondering if anyone who works in medical billing, insurance billing, or hospital administration can share some tips on what the average Joe or Jane can do to avoid ending up in situations like this. It's a huge flaw in our medical system that often leaves people feeling like they got the short end of the stick.