Real Life Medical Bill Stories: Preventing Out-of-Network Charges

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medical-billing-advocate_136007231In a recent blog post, I shared an experience I had with a local hospital who wanted a lump sum of money up front for services that had yet to be rendered when I had a health insurance plan that covered the procedure at 100%. Here, I will share more of that same experience with a focus on another problem that is occurring far too often: being billed by an out-of-network provider within an in-network facility.

My doctor had ordered an ultrasound at a local hospital. While registering in the radiology department, I was faced with opposition while trying to be proactive in preventing out-of-network charges. The registration employee asked that I sign a five-page document electronically, but automatically jumped to the fifth page for my signature. I asked her if I could read the document before signing. She reluctantly flipped to the first page and instructed me to let her know when to electronically flip the page. I came to a section about out-of-network physicians who might be involved in my care. I told the employee that I only want in-network providers involved in my care. I have health insurance and the facility was within my network, so I felt that all who were involved in my care should be in-network, too.

The employee stated that I must sign the document. I stated that I would sign if I could write on the form that I only want in-network providers involved in my care. She stated that I could not write a statement on the form. I informed her that if I could not be guaranteed that I would only receive care from in-network physicians, that I would not be having the procedure. This went back and forth for approximately 10 minutes before the employee finally agreed to let me write a statement on the document.

I should state that I feel like the registration employee was only doing her job in the manner in which she was trained. But it was very disheartening to see that this was obviously the first time she had encountered a patient who wanted to protect herself by ensuring that her radiology results would not be read by an out-of-network radiologist within an in-network facility.

Later, when I was having the ultrasound performed, I decided to ask the technician about the chance of having an out-of-network radiologist read my results of the ultrasound. She looked confused just for a moment, tilting her head, but suddenly stated that she just couldn’t see how an in-network hospital would employ any out-of-network staff. I nodded and smiled, not wanting to perform a lesson on the woes of our severely damaged healthcare system. Even she, a healthcare employee who was phenomenal at performing her job, was unaware of the potential financial traps involved in healthcare.

Although you might face opposition when trying to protect yourself from abusive medical billing, it is definitely worth it in the long run to save your financial stability. If you have received a surprise medical bill from an out-of-network provider when you were receiving care in an in-network facility and you need help, contact Medical Billing Advocates of America at 855-203-7058.



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