Consumer Watchdog is investigating a pernicious threat to your pocketbook: the out-of-network medical specialist, particularly in hospitals. We’re trying to confirm how widespread the problem is, and need your help.
Here's the scenario: Your doctor tells you that you need surgery, treatment or testing at a hospital or other specialty setting. The good news is that it’s not life threatening, so there is no need to jump in an ambulance and race over to the ER.
There's some time to do this right. You know your health insurance coverage requires you to get care in an "in-network" hospital by an "in-network" physician. So you do the research, make a few calls, and schedule the procedure.
Everything seems to go fine. The procedure is completed, and you head home.
Then you get the actual bill: It turns out that the anesthesiologist who saw you for less than five minutes before putting you under was not "in network"--even though the hospital and the doctor performing the procedure were approved providers. No one bothered to tell you. Even if they had, the likelihood of switching anesthesiologists at the last minute is close to nil. Now, the anesthesiologist wants you pay $1,500 out of pocket because he won’t accept the rate that the insurer is willing to pay.
We’ve heard of similar cases involving hospital radiologists and a few other hospital-based specialties.
Has something like this happened to you or someone you know? Please click here to tell us your story.