I learned today that the orthopedic surgeon who saw me at the hospital on the day of my accident has billed the insurance company for consultation and for surgery. Say what? I didn't have any surgery!!
In addition, while my deductible is $300, and my maximum out of pocket expense is supposed to be $3000, the insurance company will only pay what they pay for any particular procedure, and I am liable, according to my explanation of benefits, for whatever else the medical people out of network decided to charge!
Since I am doing so well physically after the accident, maybe the lesson I will need to learn from all this is to deal with my emotional reactions to unfairness. But hopefully the surgeon will back off from an exhorbitant fee for no work done. Otherwise I will apparently be responsible for paying him something like $500 a minute for the time I saw him in the hospital!!!
Scarey thing is, there is yet another surgeon to deal with, and who knows whatever other medical personel! The joys of the modern medical system!!
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Ready to support socialized medicine?
ReplyDeleteI'm sorry! I hope the surgeon takes that off, too. The insurance company ought to act as your advocate in having the "surgery" off your bill.
Makes me glad we only have $1400 in out-of-network to pay for Graham. . .sorry, Mom.
Sounds like someone is trying to gyp you! That is terrible, and there should be some way to fight it. I would think that if you told the insurance company the true story, that they might proceed against him for fraud, because that is what is happening. Maybe it would scare him enough to make him change the bill to a more truthful level!
ReplyDeleteThe joy of the modern medical system is that we do have the right to question & protest unfair billing. In a free market system, both the doctors and the insurance companies have to be somewhat responsive to their customers, or they won't have any. With socialized medicine, the consumer (us) has almost no say in anything (as experienced by us with the Canadian medical system.) Flawed as it may be, I still choose the free market system every time!
Please keep us posted as to how this works out, and good luck!