Tuesday, September 16, 2014

What Do You Mean I Owe You 1,000 Dollars!?!

                                                                   By Coleen Elkins

You have health insurance right? You know what your deductible and potential out pockets are right? We hope so.  

Do you know what balance billing is?  If not you need to.

Some doctors do not contract with insurance companies typically anesthesiologists do not. What does that mean to you? Imagine you are scheduled for an elective surgery. You visit the surgeon who is in your network and they carefully schedule you for the surgery at a hospital in your PPO insurance company’s network. It’s all good right? No so fast!  Just because your hospital is “in network” does not mean the doctors providing services within that hospital are!  You could very well end up with a large unexpected bill in your mailbox. 

How do you protect yourself? One way would be to speak to the person scheduling your surgery and ask them to make sure everyone on your surgical team is in network. If it turns out they are not it is important to ask them if they are willing to accept payment from your insurance company without balance billing you. Make sure you have the name of every person the scheduler spoke with regarding your surgery about NOT balance billing for out of network services. This way you have no surprises. 

The second scenario may be more difficult. Most emergency room doctors are not contracted with insurance companies. You will be covered for the emergency room visit to the hospital and typically have a co-pay for that visit. The doctor in the emergency room may very well not be a contracted physician and could send you a bill for the short fall after billing your insurance company.  

Make sure to share this information with your friends and family members so they can ask questions about fees for services regarding treatment of a loved one during an emergency. 

Be insurance SAAVY! You wouldn’t walk into a big box store lay down your favorite credit card and tell them you want a big screen without knowing the price of the TV would you? Of course not! 

Make sure you don’t make that mistake with your insurance card either! If you do you may end up with “sticker shock” and high blood pressure! 

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