Title misses “from an out of network oral surgeon”
-
-
-
From the article: “surprise bills are the most common in ER visits where the patient is ultimately admitted to the hospital for further treatment...often from specialists...” So why frame as “ER” problem vs “hospital” or “specialist” problem? Headlines are important.
-
Morning! I think it's fair to use ER in the headline because that is the site where the patients I'm writing about are receiving care. As I note in the article, 14 percent of ER patients who remain outpatient also face out-of-network bills.
-
Thanks for replying! Of the 14% who were discharged from ED, do you know for what % the surprise bills came from specialist consults vs. ED docs? That would be helpful to know re: how to frame and how to best address the problem (re-replying, typo in my 1st!)
-
This is from the Garmon study I cite in the piece, which unfortunately doesn't have that level of specificity. It's here: https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2016.0970 … This separate report from TX suggests its a problem that spreads across ED docs/specialists https://forabettertexas.org/surprisebills/img/2017_HW_SurpriseMedBill.pdf …
-
Separately, I think
@zackcooperYale's research on ER staffing suggests that this is a challenge that spreads pretty widely across different types of physicians working in ERs.https://www.nytimes.com/2017/07/24/upshot/the-company-behind-many-surprise-emergency-room-bills.html … -
Thanks, saw that one! Definitely some bad actors and seems like a multi-factorial problem. Here’s why I worry about ER-focused framing BTW: 1) ERs already demonized in health care, has led to misguided policy efforts & more, and...
-
2) People already scared to go to ER due to $ and I would hate to see even more avoiding ER care they need (yes, we—the entire health care and political system—really need to fix it so people aren’t afraid of bankruptcy from needed medical care)
- 4 more replies
New conversation -
-
-
Com’on Sarah- this is not an ER issue- oral surgeons are not employed by the ER- this is an “out of network surgeon issue”- please write better headlines that don’t deceive readers
-
It's an ER issue because these out-of-network surgeons are working at in-network ERs.
-
The surgeon works in the hospital. Not the ER. Surgeries take place in the OR. Different site.
-
Fair enough, but I think from the patient perspective this looks pretty different. The surgeon comes into the ER, consults with the patient there. He is working in and seeing patients in the ER.
-
If anything this illustrates the difficulty in maintaining an ER call roster. Most oral surgeons work out of offices/surgicenters. They don’t have to (and many don’t!) take ER call. Same applies to ENT, Optho, Plastics, many other specialties 1/x
-
Many hospitals frequently have big gaps in their call roster, and this is one of the reasons: they have to deal w insurance nonpayment (in addition to many other hassles).
End of conversation
New conversation -
-
-
This should become illegal, absolutely crazy for a patient to check every aspect of their care. If this continues it will be difficult to provide care
Thanks. Twitter will use this to make your timeline better. UndoUndo
-
-
-
Incredibly common. My insurance company’s advice, when my 6 mo. old went in for life saving brain surgery, was “Ask if the anesthesiologist is in network.” Docs stopped the cart into the MRI room when I asked. “Do you want us to check? Now?”
-
And what are you supposed to do if they’re not?!
- 1 more reply
New conversation -
-
-
Thank you for writing this important piece. Do you believe consumers should put pressure on companies like
@Humana, (~63% of TX hospitals having ZERO in network docs w Humana) or gov for not supporting ACA (so insurance can afford to be in TX) or hospitals or something else?Thanks. Twitter will use this to make your timeline better. UndoUndo
-
-
-
It’s a sign of how messed up things are when my first thought was, “$7,924? That’s pretty good.”
Thanks. Twitter will use this to make your timeline better. UndoUndo
-
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.