Community Chat

[Meowingkitty]

Every time I've had a bill come in from an out of network anesthesiologist I call the insurance company and they have taken care of it and I've never heard from them again.  United Health Care told me that anesthesiologists are rarely in network but they are supposed to take what the insurance pays and be done with it. I've had it happen at least 4 times in the past 3 years and have yet to pay a dime after contacting my insurance company. 

[Jordan2]

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@fthunt wrote:

Question - so you were put 'under'?   Like:  out of it?

Thankfully I've had so few surgeries I may not understand your details correctly..  When I had both eyes done - I was wide awake and listening to doc and assistants gibber-jabber.  My eye(s) were 'frozen" but nothing more.

IF that's the way they do it now - guess the bill is legit so present it to your insurance company.  They may pay all or part of it.

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@fthunt I was awake for the surgery, however I was given something that put me out for a couple of minutes. I didn't get an EOB from my insurance, I'm thinking the billing office didn't put it through to my insurance. I will make calls on Monday. 

[pdlinda]

@Texasmouse  When I had my left hip replaced in 2008 that happened to me.  I was billed out-of-pocket for the anaesthesiologist and got the same "line"  you did regarding them being independent contractors.  I got 3 other bills from various other docs involved in the procedure in the same category.

However, in 2019 when I got my right knee replaced I specifically asked PRIOR to surgery regarding any extra bills I might expect.  I had the procedure done in an orthopedic facility that only does knee/hip replacements.  I was told ALL their doctors are contracted with my insurance company and the only charge I paid was $100. for the hospitalization.

[Jordan2]

I'm the OP, I called the phone number on the bill this morning  (it is a third party that does the billing for the office). They didn't have my insurance information so didn't file a claim. I gave the woman on the line my insurance info, she told me not to pay the bill, if I get a second bill call them. I hope my insurance company pays for at least some of it. I know I will have to pay a copay or more, but I can't afford to pay $1,825. Shouldn't the facility pass along my insurance information to the doctor so he can get paid?

[Cakers3]

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@Jordan2 wrote:

I'm the OP, I called the phone number on the bill this morning  (it is a third party that does the billing for the office). They didn't have my insurance information so didn't file a claim. I gave the woman on the line my insurance info, she told me not to pay the bill, if I get a second bill call them. I hope my insurance company pays for at least some of it. I know I will have to pay a copay or more, but I can't afford to pay $1,825. Shouldn't the facility pass along my insurance information to the doctor so he can get paid?

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@Jordan2   I would think it would have been up to the anesthesiologist to find out what you insurance is-but since you have been told not to pay the bill right now it really doesn't matter who did what at this point.

Billing can be a nightmare for patients; all you could do is what you did.

Unfortunately we, the patients, have to run in circles to get things straightened out.

Good luck.

[Deree]

I don't know if this situation is comparable but when I went to the ER I was seen by a PA then an MD.  I received charges for the PA who was not in-network.  I'm not one to let things slide so I called my insurance company to complain that "no one told me -- they had my insurance info", then I called the Billing Supervisor and the hospital Patient Advocate.  The charges were dismissed sort of as a courtesy in understanding of my predicament.

Especially with something like elective surgery or any surgery known in advance It's ultimately the patient's responsibility to know if all parties are participating or not. But you may want to contact whomever you can to enlist their help should the charges be more than a copay.

[I am still oxox]

Most anesthesiologistanests are not in any network but ther is a chance if you talk to them they will adjust the fee

[SunSprite]

@Jordan2   The fact that the anesthesiologist did not have your insurance info means they are definitely operating out of a different billing system. They may or may not be in network with your insurance carrier. 

When your explanation of benefits arrives (and you should receive that first before you receive a billing statement again), make sure you look at the patient responsiblity on the eob. Hopefully they will be in network and this will not end up being a big deal. 

Even if they aren't in network though, you still have options. Many organizations will give you a "non-covered" discount, and/or discounts for payment in full. Just remember your eob doesn't have to be what you actually pay, but it will give you an idea of what your insurance says is your portion. 

Hope that made sense, good luck to you!