My daughter had elective surgery in January. She was very careful in selecting her doctor and hospital making sure they were in network. A month or so after her surgery she received a whopping bill from a MD who was the anaestheologist. She did NOT pick this doctor but her surgeon did. There is also a bill from who knows...I need to check it out but it is definitely not anyone my daughter met with pre-surgery.
Is there any defense to this type of practice among doctors?
savemanatees
Full Version: BAIT AND SWITCH
QUOTE(savemanatees @ Sep 8 2006, 10:51 AM) 
My daughter had elective surgery in January. She was very careful in selecting her doctor and hospital making sure they were in network. A month or so after her surgery she received a whopping bill from a MD who was the anaestheologist. She did NOT pick this doctor but her surgeon did. There is also a bill from who knows...I need to check it out but it is definitely not anyone my daughter met with pre-surgery.
Is there any defense to this type of practice among doctors?
savemanatees
Is there any defense to this type of practice among doctors?
savemanatees
Since it was not your choice try to appeal to the insurance company. Then negotiate withh that doctor.
This happened to us last year when we were assured that all of the doctors at our local hospital were in network. It was not true. The doctor accepted 1/4 of his bill as that is what he gets paid by other insurance companies.
QUOTE(TravelinGuy @ Sep 8 2006, 02:08 PM)
QUOTE(savemanatees @ Sep 8 2006, 10:51 AM)
My daughter had elective surgery in January. She was very careful in selecting her doctor and hospital making sure they were in network. A month or so after her surgery she received a whopping bill from a MD who was the anaestheologist. She did NOT pick this doctor but her surgeon did. There is also a bill from who knows...I need to check it out but it is definitely not anyone my daughter met with pre-surgery.
Is there any defense to this type of practice among doctors?
savemanatees
Since it was not your choice try to appeal to the insurance company. Then negotiate withh that doctor.
This happened to us last year when we were assured that all of the doctors at our local hospital were in network. It was not true. The doctor accepted 1/4 of his bill as that is what he gets paid by other insurance companies.
This happened to me when I had my daughter. There were charges from other drs that I never saw. They may have been on duty or whatever while I was there, but trust me, I know when a new OB walks into the room. You want to know him/her
I tried disputing it with the hospital and failed. The doctors were Out of network.
QUOTE(TravelinGuy @ Sep 8 2006, 03:08 PM)
QUOTE(savemanatees @ Sep 8 2006, 10:51 AM)
My daughter had elective surgery in January. She was very careful in selecting her doctor and hospital making sure they were in network. A month or so after her surgery she received a whopping bill from a MD who was the anaestheologist. She did NOT pick this doctor but her surgeon did. There is also a bill from who knows...I need to check it out but it is definitely not anyone my daughter met with pre-surgery.
Is there any defense to this type of practice among doctors?
savemanatees
Since it was not your choice try to appeal to the insurance company. Then negotiate withh that doctor.
This happened to us last year when we were assured that all of the doctors at our local hospital were in network. It was not true. The doctor accepted 1/4 of his bill as that is what he gets paid by other insurance companies.
Common problem, but you usually can appeal to the insurance company because you do NOT have a choice in the Anesthesiologists or Radiologist
The best defense? There really isn't one, but the best is to try to get them to assist you in the appeals process, if they have a competent billing staff they can probably help out a lot.
If you don't want to involve them feel free to PM me and we can work on a letter based upon what your insurance company and state etc are,.
Happened to me. Talked to the insurance company and they didn't want to do squat. I was admited to an in network hospital. Like I had a choice who read my xrays. I went through my company and they straightened the insurance company out.
Hey guys,
Thanks for all the replies. Since posting here I've been smiling and dialing on behalf of my daughter who is clueless.
I was amazed and shocked at the billing practices and just plain chicanery involved in medical billing.
The surgeon brought along an RN to "assist" her. This RN is not only out of network her services were never mentioned to my daughter. The witch got paid 50% of RAC. She hasn't sent a bill yet (the surgery was in January) but when and if she does I informed the surgeon's billing person I WILL resort to whatever legal recourse is available to my daughter to disclose this rather shady practice.
My daughter's provider is Humana. I have spent 4 days on the phone with them. The have never once sent an EOB to my daughter. I finally escalated it by threatening to contact the insurance commissioner's office which netted some results.
My advice after strugglng through all these tangled medical bills with no EOBs is that a medical consumer should get in writing any and all expenses for an elective procedure. Of course, this does not include emergencies. BUT the billing people and Humana have been ruthless and not 100% kosher in my daughter's case. BTW she lives in Louisville, KY, corporate home of Humana!
savemanatees
Thanks for all the replies. Since posting here I've been smiling and dialing on behalf of my daughter who is clueless.
I was amazed and shocked at the billing practices and just plain chicanery involved in medical billing.
The surgeon brought along an RN to "assist" her. This RN is not only out of network her services were never mentioned to my daughter. The witch got paid 50% of RAC. She hasn't sent a bill yet (the surgery was in January) but when and if she does I informed the surgeon's billing person I WILL resort to whatever legal recourse is available to my daughter to disclose this rather shady practice.
My daughter's provider is Humana. I have spent 4 days on the phone with them. The have never once sent an EOB to my daughter. I finally escalated it by threatening to contact the insurance commissioner's office which netted some results.
My advice after strugglng through all these tangled medical bills with no EOBs is that a medical consumer should get in writing any and all expenses for an elective procedure. Of course, this does not include emergencies. BUT the billing people and Humana have been ruthless and not 100% kosher in my daughter's case. BTW she lives in Louisville, KY, corporate home of Humana!
savemanatees
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