Healthcare - out of network expenses
Sep 25th 2019, 4:15 pm
#31
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Joined: Oct 2003
Posts: 0
Re: Healthcare - out of network expenses
We had a PPO for 18 years. My husband nor myself cannot remember ever having any doctor/office/hospital ever mentioning or explaining insurance coverage or out of pocket expenses. Nor has the cost of a consultation/procedure/tests/surgery/follow up care etc ever been mentioned. Apart from whether they are in network or not, how do they know what your insurance company will cover, or what your costs will be?
Sep 25th 2019, 6:43 pm
#32
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Joined: Aug 2013
Location: Eee Bah Gum
Posts: 4,129
Re: Healthcare - out of network expenses
We also had PPO through my employer, including as a retiree, for 29 years. Their networks were well defined but we did once choose a facility that was in network but once all the bills rolled through, one of the 2 labs they used was not in network and we had to argue over a $1,500 bill for about a year.
Sep 28th 2019, 6:39 pm
#33
Banned
Joined: Sep 2019
Posts: 8
Re: Healthcare - out of network expenses
Preferably I would do away with insurance and go to a cash based model where patients pay directly an agreed price for the treatment or consultation. Lab work/imaging would again be charged at a fixed price.
Sep 28th 2019, 7:17 pm
#34
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Joined: Oct 2003
Posts: 0
Re: Healthcare - out of network expenses
Sorry but as a physician this is a ridiculous thing to say. Given there are thousands of plans etc how do you expect a clinician to know which one is or isnt in-network? Enough things for us to remember but not that thank you!
Preferably I would do away with insurance and go to a cash based model where patients pay directly an agreed price for the treatment or consultation. Lab work/imaging would again be charged at a fixed price.
Preferably I would do away with insurance and go to a cash based model where patients pay directly an agreed price for the treatment or consultation. Lab work/imaging would again be charged at a fixed price.
Sep 28th 2019, 7:24 pm
#35
Austin. TX.
Joined: Sep 2013
Posts: 5,930
Re: Healthcare - out of network expenses
Sorry but as a physician this is a ridiculous thing to say. Given there are thousands of plans etc how do you expect a clinician to know which one is or isnt in-network? Enough things for us to remember but not that thank you!
Preferably I would do away with insurance and go to a cash based model where patients pay directly an agreed price for the treatment or consultation. Lab work/imaging would again be charged at a fixed price.
Preferably I would do away with insurance and go to a cash based model where patients pay directly an agreed price for the treatment or consultation. Lab work/imaging would again be charged at a fixed price.
Considering the amounts doctors are paid, surely it isn't too much to ask for one bloody phone call to the patient's insurers to check and that could probably be done by one of the many minions running around.
In the OP's case, this wasn't an emergency op, it was planned in advance so there would be time for a wee bit of admin. ESPECIALLY cosidering the ******* $10k it cost the patient
ETA
this kind of ****wittery aka balance billing is illegal in TX and other states. Funny how it can be done eh?
Last edited by petitefrancaise; Sep 28th 2019 at 7:27 pm.
Sep 28th 2019, 7:53 pm
#36
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Joined: Aug 2013
Location: Eee Bah Gum
Posts: 4,129
Re: Healthcare - out of network expenses
You have got to be JOKING!
Considering the amounts doctors are paid, surely it isn't too much to ask for one bloody phone call to the patient's insurers to check and that could probably be done by one of the many minions running around.
In the OP's case, this wasn't an emergency op, it was planned in advance so there would be time for a wee bit of admin. ESPECIALLY cosidering the ******* $10k it cost the patient
ETA
this kind of ****wittery aka balance billing is illegal in TX and other states. Funny how it can be done eh?
Considering the amounts doctors are paid, surely it isn't too much to ask for one bloody phone call to the patient's insurers to check and that could probably be done by one of the many minions running around.
In the OP's case, this wasn't an emergency op, it was planned in advance so there would be time for a wee bit of admin. ESPECIALLY cosidering the ******* $10k it cost the patient
ETA
this kind of ****wittery aka balance billing is illegal in TX and other states. Funny how it can be done eh?
When it happened to me it was a scheduled routine colonoscopy, my 3rd. I did my own checking ahead to ensure that the facility, physician, anesthesiologist etc were in network. However they removed a small polyp, less than 5mm, and without checking with me or my insurer sent it to a lab outside of my network and then billed me $1,500 for the histology. (It was negative, not cancer or pre cancer). It took a year of appeals to get it sorted and I ended up paying $30. I don’t believe they could not have checked my insurance or waited a day and asked me to check and/or select one of the labs in my plan’s network.
Sep 28th 2019, 10:56 pm
#37
Banned
Joined: Sep 2019
Posts: 8
Re: Healthcare - out of network expenses
Am a salaried IM PCP with admitting privileges. Again how am I supposed to know if I or a lab is in a network or not of umpteen different policies. Ask the administrators in billing or even your insurance company etc it's their job not mine. I am more concerned in keeping up to date with latest treatments etc
I resent this idea of doctors being overpaid which is perpetuated only by Brits not Americans surprisingly. Lawyers and accountants seem to earn a good deal more but for some reason a doctor which takes endless years of training and tough exams isn't entitled to that!
I resent this idea of doctors being overpaid which is perpetuated only by Brits not Americans surprisingly. Lawyers and accountants seem to earn a good deal more but for some reason a doctor which takes endless years of training and tough exams isn't entitled to that!
Sep 28th 2019, 11:14 pm
#38
Account Closed
Joined: Oct 2003
Posts: 0
Re: Healthcare - out of network expenses
Am a salaried IM PCP with admitting privileges. Again how am I supposed to know if I or a lab is in a network or not of umpteen different policies. Ask the administrators in billing or even your insurance company etc it's their job not mine. I am more concerned in keeping up to date with latest treatments etc
I resent this idea of doctors being overpaid which is perpetuated only by Brits not Americans surprisingly. Lawyers and accountants seem to earn a good deal more but for some reason a doctor which takes endless years of training and tough exams isn't entitled to that!
I resent this idea of doctors being overpaid which is perpetuated only by Brits not Americans surprisingly. Lawyers and accountants seem to earn a good deal more but for some reason a doctor which takes endless years of training and tough exams isn't entitled to that!
Sep 28th 2019, 11:15 pm
#39
Austin. TX.
Joined: Sep 2013
Posts: 5,930
Re: Healthcare - out of network expenses
US doctors ARE paid more than other countries though.....
https://naibuzz.com/10-countries-hig...alaries-world/
and the bill for the hospital drs comes from their offices, not from the hospital, so I'm not sure that offloading the responsibility is relevant. Like I said, quite a few states have legal protection for patients against balance billing so it is possible to figure it out.
If you didn't want to bother your pretty little head over billing issues, then perhaps you might have stayed in the NHS?
Or you could go to France and earn about 1/3 of your current salary?
https://naibuzz.com/10-countries-hig...alaries-world/
and the bill for the hospital drs comes from their offices, not from the hospital, so I'm not sure that offloading the responsibility is relevant. Like I said, quite a few states have legal protection for patients against balance billing so it is possible to figure it out.
If you didn't want to bother your pretty little head over billing issues, then perhaps you might have stayed in the NHS?
Or you could go to France and earn about 1/3 of your current salary?
Sep 28th 2019, 11:25 pm
#40
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: Healthcare - out of network expenses
expatdoc Last Activity: Sep 9th 2019 10:19 am (banned)
ceat Joined: Sep 18th 2019
Just sayin'
ceat Joined: Sep 18th 2019
Just sayin'
Sep 29th 2019, 12:04 am
#41
Austin. TX.
Joined: Sep 2013
Posts: 5,930
Re: Healthcare - out of network expenses
Sep 29th 2019, 12:21 am
#42
Account Closed
Joined: Jan 2006
Posts: 0
Re: Healthcare - out of network expenses
So seems based on that link, if a GP better in Canada but if a specialist better in the US.
Canada comes in #2 highest paid doctors yet still spends less a fair chunk less on healthcare last I looked.
Canada comes in #2 highest paid doctors yet still spends less a fair chunk less on healthcare last I looked.
US doctors ARE paid more than other countries though.....
https://naibuzz.com/10-countries-hig...alaries-world/
and the bill for the hospital drs comes from their offices, not from the hospital, so I'm not sure that offloading the responsibility is relevant. Like I said, quite a few states have legal protection for patients against balance billing so it is possible to figure it out.
If you didn't want to bother your pretty little head over billing issues, then perhaps you might have stayed in the NHS?
Or you could go to France and earn about 1/3 of your current salary?
https://naibuzz.com/10-countries-hig...alaries-world/
and the bill for the hospital drs comes from their offices, not from the hospital, so I'm not sure that offloading the responsibility is relevant. Like I said, quite a few states have legal protection for patients against balance billing so it is possible to figure it out.
If you didn't want to bother your pretty little head over billing issues, then perhaps you might have stayed in the NHS?
Or you could go to France and earn about 1/3 of your current salary?
Sep 29th 2019, 12:39 am
#43
Banned
Joined: Sep 2019
Posts: 8
Re: Healthcare - out of network expenses
US doctors ARE paid more than other countries though.....
https://naibuzz.com/10-countries-hig...alaries-world/
and the bill for the hospital drs comes from their offices, not from the hospital, so I'm not sure that offloading the responsibility is relevant. Like I said, quite a few states have legal protection for patients against balance billing so it is possible to figure it out.
If you didn't want to bother your pretty little head over billing issues, then perhaps you might have stayed in the NHS?
Or you could go to France and earn about 1/3 of your current salary?
https://naibuzz.com/10-countries-hig...alaries-world/
and the bill for the hospital drs comes from their offices, not from the hospital, so I'm not sure that offloading the responsibility is relevant. Like I said, quite a few states have legal protection for patients against balance billing so it is possible to figure it out.
If you didn't want to bother your pretty little head over billing issues, then perhaps you might have stayed in the NHS?
Or you could go to France and earn about 1/3 of your current salary?
Sep 29th 2019, 12:55 am
#44
SUPER MODERATOR
Joined: Dec 2005
Posts: 88,017
Re: Healthcare - out of network expenses
Sorry about no full stops my phone seems to have stopped typing them
Sep 29th 2019, 1:12 am
#45
Concierge
Joined: Jan 2013
Location: Western Australia
Posts: 21,138
Re: Healthcare - out of network expenses
To be fair the vast majority of people who move to the US for career purposes, including medical practitioners, would just be looking to improve their lives like most of us. I have all the respect in the world for good medical practitioners and I don't think 'ceat' is representative of the profession, in fact I don't think he/she is a medical practitioner at all. Unless working in the hospital laundry counts.