A few months ago I had a preventative procedure that is supposedly 100% covered by my insurance plan. Both the specialist, and the facility where I had the procedure done, are in-network providers in my insurance plan. I even called the insurance company to confirm their in-network status before scheduling it.
The day of the procedure I met the specialist, and others, including the anesthesiologist. I met the anesthesiologist less than a half hour before he put me under for the procedure.
After the procedure I get a notice from insurance that the anesthesiologist wasn’t covered because he was out-of-network. Then I get the bill from the anesthesiologist— for a whopping $2000. I look into it and apparently he is not a part of that particular practice, and is part of a separate anesthesiology practice that is out of network on my plan. WHAT???
The specialist’s clinic billing dept. instructed me to file an appeal with insurance, so I did so, and it was denied. Filed another appeal and same result, and I now have no more appeals left.
Now both practices are kind of giving me the runaround. But I’m only dealing with people in the billing department. I spoke with supervisors and they just instructed me to file another appeal, which I can’t do. I kind of sympathize with the anesthesiologist practice, because they were hired to do a job and they did it.
But what is the expectation for a patient about to undergo a procedure? confirm that every person in the room is in-network, and upon finding out that they are out of network, inform them that I am refusing the procedure today unless they provide an in-network anesthesiologist?
If anyone has any suggestions as to any possible recourse, please let me know. My opinion is that the specialist’s clinic is responsible for settling this outstanding amount… but i don’t think my opinion is going to help wipe out my outstanding bill of $2000.
Please help! Thank you!
submitted by /u/growlingdoggie
[link] [comments]
A few months ago I had a preventative procedure that is supposedly 100% covered by my insurance plan. Both the specialist, and the facility where I had the procedure done, are in-network providers in my insurance plan. I even called the insurance company to confirm their in-network status before scheduling it. The day of the procedure I met the specialist, and others, including the anesthesiologist. I met the anesthesiologist less than a half hour before he put me under for the procedure. After the procedure I get a notice from insurance that the anesthesiologist wasn’t covered because he was out-of-network. Then I get the bill from the anesthesiologist— for a whopping $2000. I look into it and apparently he is not a part of that particular practice, and is part of a separate anesthesiology practice that is out of network on my plan. WHAT??? The specialist’s clinic billing dept. instructed me to file an appeal with insurance, so I did so, and it was denied. Filed another appeal and same result, and I now have no more appeals left. Now both practices are kind of giving me the runaround. But I’m only dealing with people in the billing department. I spoke with supervisors and they just instructed me to file another appeal, which I can’t do. I kind of sympathize with the anesthesiologist practice, because they were hired to do a job and they did it. But what is the expectation for a patient about to undergo a procedure? confirm that every person in the room is in-network, and upon finding out that they are out of network, inform them that I am refusing the procedure today unless they provide an in-network anesthesiologist? If anyone has any suggestions as to any possible recourse, please let me know. My opinion is that the specialist’s clinic is responsible for settling this outstanding amount… but i don’t think my opinion is going to help wipe out my outstanding bill of $2000. Please help! Thank you!
submitted by /u/growlingdoggie [link] [comments]Read Morer/HealthInsurance