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My wife had to go to the ER and we went to a hospital that was in network. The hospital is indeed in network but the fucking ER is a separate entity and was not. I guess we should have been better informed consumers. /s
ER was in-network. The nurse and doctor was also in-network. The second nurse, who connected me to the ECG, and the person who read the ECG was not in-network. No way of knowing at the time. Balance billing was permitted in that state at that time, which out-of-network provider used to the full extent.
I’m still salty about that.
That part is messed up. You shouldn't be dealing with individual contractors as a patient. All billing should go through the hospital, and be considered in-network provided the hospital is in-network, regardless of what kind of specialist sees you there. Any exception, such as bringing in someone who doesn't normally work there to treat a rare condition, should require separate and specific authorization from the patient in advance.
Ridiculous isn’t it? I had my annual physical a few weeks back, which for me is filling an online form and having my blood pressure read and a few blood tests. $550, insurance pays for everything.
Well. Almost. Turns out 2 of my blood tests were not covered by some healthcare bill passed in 2007. $267. And the mole I asked to be checked, billing code wasn’t covered as standard checkup, and so that question was $240. Mole was benign, and surprisingly didn’t result in some convenience fee.
That is seriously fucked up.
For me, I called my insurance on the phone while bleeding profusely and wanted to make sure I went to the right hospital. I still got hit with out of network bills.