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The fact that there are even hospital emergency rooms that staff nothing by doctors who don't take any insurance is complete BS and should not be allowed. Luckily, my sister-in-law is an insurance lawyer (does mostly health insurance) and took care of it for me. But for those people who don't have that resource, they are going to be hit with a bill that could be well into the thousands of dollars.
And it does not have to be an ER visit to get "surprise" billed.
My wife needed rotator cuff surgery. The hospital, the anesthesiologist, and the surgeon were all in-network. A month later we get a bill from a "surgical assistant" for $1000. Supposedly the surgeon decided he needed help, unbeknownst to us before, during, or after the surgery.
Long story short, it turned out that no "surgical assistants" were in-network with any insurance plans. Much like ER doctors. My suspicion is that the SA was the surgeon's wife. Our insurance, and the State's insurance commission, were no help.
And it does not have to be an ER visit to get "surprise" billed.
My wife needed rotator cuff surgery. The hospital, the anesthesiologist, and the surgeon were all in-network. A month later we get a bill from a "surgical assistant" for $1000. Supposedly the surgeon decided he needed help, unbeknownst to us before, during, or after the surgery.
Long story short, it turned out that no "surgical assistants" were in-network with any insurance plans. Much like ER doctors. My suspicion is that the SA was the surgeon's wife. Our insurance, and the State's insurance commission, were no help.
My wife needed rotator cuff surgery. The hospital, the anesthesiologist, and the surgeon were all in-network. A month later we get a bill from a "surgical assistant" for $1000. Supposedly the surgeon decided he needed help, unbeknownst to us before, during, or after the surgery.
Long story short, it turned out that no "surgical assistants" were in-network with any insurance plans. Much like ER doctors. My suspicion is that the SA was the surgeon's wife. Our insurance, and the State's insurance commission, were no help.
Just an outright scam to get more money.
Most surgeons use a First Assist in the OR. It's not because they need help and it's not a scam. It's common practice and allows surgeons to focus on the intricacies of the case, be more efficient and it ultimately improves patient care. They perform functions such as retraction, suction, wound closure etc. It's not an entry level position, and it's not a Surgical Technologist. Surgical First Assistants are almost always certified and some have nursing backgrounds, so unless your surgeon's wife had those qualifications, it wasn't her. My spine surgeon used an NP as his First Assistant and she sent me a bill months afterwards as well and like you, I wasn't particularly happy about it, but I understand what they do and why they're used.
Last edited by Texas Ag 93; 02-20-2020 at 06:10 PM..
I went to the Netherlands.Got a bladder infection and didn't have travel insurance.
ER 2 days IC, 3 days hospital. Was 8000 Euro. About 9000 Dollars. Here it would be like 10 times.
And the food was better....
The level of care is the same as in the US. Believe me, I spend 9 weeks in a hospital here after a heart attack.
And it does not have to be an ER visit to get "surprise" billed.
My wife needed rotator cuff surgery. The hospital, the anesthesiologist, and the surgeon were all in-network. A month later we get a bill from a "surgical assistant" for $1000. Supposedly the surgeon decided he needed help, unbeknownst to us before, during, or after the surgery.
Long story short, it turned out that no "surgical assistants" were in-network with any insurance plans. Much like ER doctors. My suspicion is that the SA was the surgeon's wife. Our insurance, and the State's insurance commission, were no help.
Just an outright scam to get more money.
Now, this ^^^ is exactly what I was concerned about 2-1/2 weeks ago when I was about to have a total knee replacement.
I specifically checked with my insurance company beforehand because while I knew that my surgeon and the hospital were in-network (and my in-network out-of-pocket maximum for the year is $1,500), I had no idea who the surgeon would have working with him. With my insurance at least, everything in the OR is covered as in-network BECAUSE the patient has no control over it. What a sane -- and unexpected -- policy!!
It's interesting to see the bills. Say one item is billed at $30,000, but the insurance-company-negotiated rate is $12,000, so that's what they pay (and the hospital accepts it as payment in full). And of course that's only 1 item of many that are being billed. I'm assuming that people without insurance are billed the full rate, which of course most people would not be able to pay ...
What an INSANE system we have. Totally freakin' insane.
And it does not have to be an ER visit to get "surprise" billed.
My wife needed rotator cuff surgery. The hospital, the anesthesiologist, and the surgeon were all in-network. A month later we get a bill from a "surgical assistant" for $1000. Supposedly the surgeon decided he needed help, unbeknownst to us before, during, or after the surgery.
Long story short, it turned out that no "surgical assistants" were in-network with any insurance plans. Much like ER doctors. My suspicion is that the SA was the surgeon's wife. Our insurance, and the State's insurance commission, were no help.
Ironically, I was listening to the Clark Howard podcast on my way home today. A woman called in about a recent experience with a mammogram. After a certain age, mammograms are covered 100% by insurance. I get one every year, and I pay nothing out of pocket. This women actually verified that the doctor referring her was in-network and the place performing the mammogram were in network. All assured her they were. Well, guess what? The radiologist they sent it to read was a contractor and didn't take insurance. So guess who needs to pay for it?
There's a reason absolutely no country models any part of their healthcare system after the US.
It make more sense for you to post your story instead of a newspaper opinion piece.
In emergencies there is no time to negotiate anything, when it comes to healthcare just get it, argue later.
As a foreign import I know American healthcare is second to none, in the UK emergency room visits often entail a 12 hour wait, many people give up, go home and die.
Its a horror story out there.
Too many people on the ball and they're getting older by the second. Its impossible to treat all of them. Logistically, not enough doctors, not enough $$$$'s not enough space. In America you get treated royally if you have Cadillac insurance that costs roughly $3000/mo. Those with small policies, high deductibles, high co-pays, minimum coverage get treatment roughly equal to UK's. It's the natural order of things as medicine slowly declines from not having kept up with the aging demographic.
The system is pretty efficient outside the U.S. in my experience. I'm in Spain for the winter and went to the hospital a few times to get arthritis treatments. People in the waiting room took a number and were seen in about 15 min. No one was doing any paperwork or billing. My MRI was $231 since I was private pay. I received my own scans and x Ray's the same day. I was informed ahead the exact cost of everything.
The ER in Ecuador where we retired took care of me immediately for my hip dislocation and care was attentive and respectful. Best of all, no billing, no extra charges...all included in our $80 a month national plan.
It is sad the disgraceful RIP offs going on in the States. Like $30,000 for a kidney stone. In Spain, it's $1,400.
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