Emergency Care

[zoare200]

My 1 year old daughter fell and cut her lip all the way through. We went to the local hospital, that is in network coverage. The insurance company paid the Hospital as in-network and the doctor as in-network. Now we are getting bills for the doctor as out of network. It seems that the doctors are not on our plan but the hospital is. So the doctor group is saying I owe close to $500 and the insurance company says I owe $41.

How can a in network hospital have out of net-work doctors. This was emergency care, what am I suppose to do ask every doctor to fill out a form? Most doctors do not even know what insurances they take.

Our insurance first told us that there was a "breech policy" with the hospital that meant all doctors are under the hospital insurance contract. The insurance company talked to the doctors office and worked everything out.

Now I get a bill saying they are going to send me to collections in ten days. Calling back the insurance company I get a different answer that the doctors can bill what they want to, but they will look at paying it. After all we did not have choice of the doctor and it was an emergency. This will take 10 days. Mean while I will get my credit digged when I was following the rules, expect they really do not tell you the rules.

What can I do?

[RememberingMama]

Insurance co are all out for themselves. My disabled fathers medicare part d is saying that they will dis enroll him if he doesn't pay a large premium and he needs his meds, we just lost our mom this past march due to a surgical error at out local hospital which is only a block away from us so I won't take my father there at all! We go 33 miles to Cincinnati for care. He's suffering from some kind of stomach problems and we can't get him the care he needs right away.

I'm new here also just started today, found about about this website a week ago, it's been helpfull.

Best of luck to you for your insurance my dad is on the phone day and night with his (cigna rx)

Hope your kid is ok, best of luck!

[adenisi01]

Originally Posted by zoare200

My 1 year old daughter fell and cut her lip all the way through. We went to the local hospital, that is in network coverage. The insurance company paid the Hospital as in-network and the doctor as in-network. Now we are getting bills for the doctor as out of network. It seems that the doctors are not on our plan but the hospital is. So the doctor group is saying I owe close to $500 and the insurance company says I owe $41.

How can a in network hospital have out of net-work doctors. This was emergency care, what am I suppose to do ask every doctor to fill out a form? Most doctors do not even know what insurances they take.

Our insurance first told us that there was a "breech policy" with the hospital that meant all doctors are under the hospital insurance contract. The insurance company talked to the doctors office and worked everything out.

Now I get a bill saying they are going to send me to collections in ten days. Calling back the insurance company I get a different answer that the doctors can bill what they want to, but they will look at paying it. After all we did not have choice of the doctor and it was an emergency. This will take 10 days. Mean while I will get my credit digged when I was following the rules, expect they really do not tell you the rules.

What can I do?

Talk to management with the Hospital!!! You were in a in-network hospital and should not pay anymore.

[Githyankee]

I too think it would be good to talk to the billing department of that hospital. Is the doctor who saw your child an intern? This may be part of the issue.

[SpineAZ]

Contact billing at the hospital and the insurance company. Explain the predicament and ask that they hold any bills until the two parties can work it out. If you have the ability you could pay a portion of the bill and get refunded later if insurance does cover it.

I had this once with a surgery where the anesthesiologist, who I did not choose, was not in-network. It took a few phone calls but my insurance company resolved it with the doctor.