Orlando Health and doctors not taking same insurance as the hospital (maintenance, professionals)

[olderandwiser456]

I was looking at the Orlando Health website and in the insurance section, the following statement was included on the site. How would that work in the ER at Orlando Regional Medical Center, for example?

"Please note: Healthcare practitioners who provide services in the hospital may or may not participate with the same health insurers or health maintenance organizations as the hospital. It is recommended to confirm/contact the healthcare practitioner who will provide services in the hospital to determine which health insurers and health maintenance organizations the practitioner participates in as either a network provider or preferred provider."

Has anyone had any experiences with obtaining services from healthcare professionals that were not participating in your insurance, Medicare for example, but you didn't know it beforehand, such as an urgent care or ER situation?

Plus, in a complex procedure, such as surgery, how would you know in advance who all the personnel involved are, such as radiologists, anesthesiologists, other docs who might be assisting, etc, in addition to the surgeon doing the procedure?

Medicare doesn't have a "network" (since any facility or doc accepting medicare will take those patients). But the statement on the Orlando Health website says docs may not participate in the same insurance plans as the hospitals, and that would include medicare.

[olderandwiser456]

Just a quick follow-up: I talked with Billing at Orlando Health this morning, and the representative confirmed that ER doctors (or other docs) may not take the same insurances as the the hospital accepts. We discussed the issue of someone going to the ER, and the rep agreed that patients can get large "surprise" bills from docs in an ER later on who don't take your insurance, and you have no way of knowing ahead of time if you are in an emergency situation.

I think this is an important issue for anyone considering Orlando Health as their provider.

[olderandwiser456]

Good article explains the insurance situation in ERs very well.

https://www.vox.com/health-care/2018...-costs-america

[boy3365]

As your linked article indicates, that's more of a national problem than an Orlando Health problem. Pretty scary.