Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member Latest Breaking News Editorials & Other Articles General Discussion The DU Lounge All Forums Issue Forums Culture Forums Alliance Forums Region Forums Support Forums Help & Search

Health

JayhawkSD

(3,163 posts)

28. Technically, yes but insurance may pay the charge

Reply to NYC_SKP (Original post)

Wed Jul 9, 2014, 01:49 AM

Jul 2014

I had a hospital bull where they outsourced lab work to an "out of network" provider. They billed me for the amount that was not covered dur to it not being "in network" and I simply wrote a brief letter saying that the choice of provider was made by the hospital, not by me; that I had chosen an "in network" hospital and should not be penalized for any choices they made. The insurance company did not argue and voided the charge.

Edit history

Please sign in to view edit histories.

Recommendations

0 members have recommended this reply (displayed in chronological order):

37 replies

= new reply since forum marked as read

Highlight:

Can an "in network" hospital bring in "out of network" physicians who you then have to pay???? [View all] NYC_SKP Jul 2014 OP

Not sure, SKP, contracts and insurance being what they are, elleng Jul 2014 #1

Thank you! NYC_SKP Jul 2014 #2

If there was no "in network" physician at that hospital who was there and able to handle your case Warpy Jul 2014 #7

Thanks, Warpy! NYC_SKP Jul 2014 #9

ARTICLE: Anthem lists Stanford area doctors as in-network, turns out they are not. NYC_SKP Jul 2014 #8

Could be. elleng Jul 2014 #11

That is with all insurance programs from medical to dental yeoman6987 Jul 2014 #13

They make exceptions for emergency services, I had a lot of things covered. NYC_SKP Jul 2014 #17

I wish you the best of luck yeoman6987 Jul 2014 #21

Oh God, I feel for you! MannyGoldstein Jul 2014 #3

Well, they do bring paperwork to read and sign as you're laying on a gurney in the hallway. NYC_SKP Jul 2014 #6

That's under duress. What choice did you have? MannyGoldstein Jul 2014 #10

Thanks. I did a little research. NYC_SKP Jul 2014 #12

As a member of the Medico-Industrial complex, I can assure you MannyGoldstein Jul 2014 #19

It's SUCH a racket Brainstormy Jul 2014 #34

Also complain to the hospital for not informing you they accept ACA, but don't ride herd on docs. Hoyt Jul 2014 #4

Will do, it takes a shitload of phone calls to get anywhere. NYC_SKP Jul 2014 #5

Rest. elleng Jul 2014 #14

Good advice. They aren't likely to pressure patient for months, and even then there are limits on Hoyt Jul 2014 #26

Yes and they'll be paid the undisputed amounts initially, elleng Jul 2014 #27

With my wife in Stanford for a total of a month in 2012 DJ13 Jul 2014 #15

This message was self-deleted by its author lostincalifornia Jul 2014 #18

Complicating matters, CoveredCalifornia had my correct birthdate, Anthem screwed it up. NYC_SKP Jul 2014 #20

This message was self-deleted by its author lostincalifornia Jul 2014 #24

This message was self-deleted by its author lostincalifornia Jul 2014 #22

This message was self-deleted by its author lostincalifornia Jul 2014 #16

The short answer is yes, but give 'em hell. Daemonaquila Jul 2014 #23

thank you for the help and the links. NYC_SKP Jul 2014 #25

Technically, yes but insurance may pay the charge JayhawkSD Jul 2014 #28

bark up the chain. mopinko Jul 2014 #29

Hey sister! NYC_SKP Jul 2014 #30

stbex's secret plan- you dont have to hit anyone with a hammer if you play it right. mopinko Jul 2014 #31

This sounds eerily familiar. WilliamPitt Jul 2014 #32

Thanks! Fortunately, the CoveredCalifornia representative was very kind and helpful! NYC_SKP Jul 2014 #36

I saw an article just this morning about a lawsuit against Anthem . . . StatGirl Jul 2014 #33

Thanks, this is most helpful in building my case. NYC_SKP Jul 2014 #35

Great! StatGirl Jul 2014 #37