A question sort-of related to my story today: I’m having a baby in a few weeks. My OB is in-network. My hospital is in-network. But I’m not sure about the anesthesiologist — largely because I don’t know who he or she will be! How can do I avoid a surprise bill?
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The other wrinkle here is I don’t really have control over which anesthesiologist is on-call when I’m at the hospital. Anyway, situations like these seem to put the consumer in a pretty tough situation.
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I write about health care for a living. I have access to a lot of experts in medical billing. But I still don’t have a great idea how to figure out if the anesthesiologist I’ll see will be in my network or out of it.
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I’ve heard those lists aren’t even accurate/up to date
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Most anesthesiology departments are staffed by a single group, and often have a single group contract for all docs within the practice. It would be highly unusual for one to individually be nonparticipating. Also: check the pediatricians, that’s always a big unexpected one
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If your doctor orders lab tests that are not performed at your hospital, they may be sent to an out-of-network lab. Some of these labs "direct-bill" patients, and then this would be an out-of-network expense that can't be predicted or controlled
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The hospital where my son was born advised me to ask the anesthesiologist who shows up if he's in my network and go from there. My wife threatened me with bodily harm if I did anything to prevent him from doing his work when she learned about this.
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Wondering if you can write on the admissions forms above your signature that you only agree to pay in-network costs, take a picture of the forms, and keep for future reference if needed. Say you didn't agree to pay it if you get charged out of network
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One good tactic though is to demand to see an in-network staff member and refuse to sign anything and threaten to walk out until they write it in the agreement. You'd be surprised that while hospitals/clinics act thick-skinned, in the end, they'll usually cave.
#freemarket
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Sarah, can you share the prenatal/pregnancy books and articles you’ve found the most helpful and enlightening. You briefly mentioned one in the lead discussion. We’d love to know.
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Ours was in network during the work-day, but out of network at 2am when we actually needed him. Utter madness.
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Most anesthesiologists don’t participate with insurance anyhow. Because they don’t have to. Captive audience. Literally. They can paralyze you.
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That is not true for hospital based practices. It is usually a requirement of the hospital contract with the anesthesia group. I have worked for several mid-atlantic groups and we always take every insurance.
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Ask if they use nurse anesthetists. I’ve never worked in OB, but in surgery, there’s usually 1 or 2 Anesthesiologists (MD’s) that oversee the nurse anesthetists. It’s the nurse anesthetists that are actually the ones working in surgery. It’s quite surprising to get 2 bills.
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The anesthesiologist for my wife’s c-section normally did cardiac surgeries at another local hospital in the same health system. So I would consider that a point against it working.
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Why is the responsibility on the patient?? The *providers* should figure this shit out and coordinate accordingly.
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Contractually, I recommend requesting & reviewing the health plan’s summary plan description. It should outline the rules governing these hidden provider situations. Depending on who negotiated the document, you might be pleasantly surprised re the terms.
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