Suggested Reading: Patients Are Billed for Care They Didn’t Know They Got
After three-hour neck surgery, Peter Drier had anticipated bills from the hospital, his surgeon and the anesthesiologist. He knew his insurance would cover most of those costs. What he hadn’t anticipated was the bill for $117,000 from an “assistant surgeon” he didn’t even know.
Welcome to the world of “drive-by doctoring,” explained by the New York Times in a long, cautionary tale about how physicians and other medical providers help each other in caring for patients. The Times says it’s increasingly common that the helpers – medical experts, assistants, consultants and other hospital employees – charge patients or their insurers hefty fees, and might be summoned even when the need for them is questionable.
Patients usually don’t realize the helpers been involved until their bill arrives. And if the assistant/consultant isn’t part of the patient’s insurance network, it can be a whopper.
The practice is called “balance billing”: hospitals, clinics, labs and other medical facilities bill patients for the balance between what they want to charge and what the insurance company reimburses … or doesn’t.
Balance billing is illegal for Medicare patients, and in most states when privately insured patients stay in network for their care.
The Times story shows not only how huge these charges can be, but also how patients and/or their insurance companies can respond, and that hospital bills, notoriously long and detailed, often contain errors you should dispute. Often patients can achieve financial recourse after the fact, but sometimes not.
Read the whole story here.