[schwefel]

My son had tubes put in and adenoids taken out. BFD. It is his third set of tubes. Fairly routine at this point.

We were pre-certified by our insurance, through the hospital. "You will have to pay about $1000." Fine, whatever.

He goes and gets it done. We get the EOB today.

The MOTHER%^&$#@$%@# anesthesiologist is out of network. (The hospital and the surgeon on in network, but not the anesthesiologist.)

As a refresher for those who have not looked at their insurance schedule lately, here is how it works, more or less:

In Network: Insuance company has a contact with the hosipital. Billing code X is paid Y. This is regardless of whatever the hospital has on their "price list." It already has been prenegotiated.

Out of network: Hospital charges whatever is on their pricelist and sends it to the insurance company. The insurance compay ignores what the charge is and pays X% of what their resonable and customary table tells them it should be. You (the insured) are liable for the remainder.

$1300 for the anesthesiologist for five minutes of anesthesia that required no needles. OVER AND ABOVE WHAT THE INSURENACE PAID!!!! (Don't get me wrong, I understand that the anesthesiologist is, and needs to be, expensive. The liability potential is huge and the skill needed is quite high.)

This is the $%^&$% hospital playing fast and loose. While I have no direct knowledge to their operating procedure, I would bet my next paycheck that the anesthesiologist not being in network is completely intentional and desigened to enhance the bottom line.

Instead of that steaming pile horse **** they call health care reform (takeover) this is the kind of **** that needs to be reformed.

I am furious!!!!!!!

[orangello]

At least there is no interest on medical debt. Let it sit for as long as your credit can take it, then contact the anesthesiologist's office by mail with a settlement offer.

[opaww]

Send them $10 a month

[SecPro]

I got a **** load of medical bills there waiting to be paid one day.
I feel your pain!!!

[schwefel]

Originally Posted by SecPro

I got a **** load of medical bills there waiting to be paid one day.
I feel your pain!!!

It is not so much the amount of the bill, it is how the hospital went about it.

I would rather give a layer $5,000 to successfully fight it than to give them 1 red cent over and above the precert amount.

F 'em

[SecPro]

We got screwed when the wife went in for surgery last year. The hospitals are crooks and I think with the new health care crap its going to get worse on all ends.
Allot of folks can't even afford to keep up there regular health coverage due to all the BS.