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Healthcare - Is this normal?

Healthcare - Is this normal?

Old Jul 18th 2013, 12:47 am
  #16  
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Default Re: Healthcare - Is this normal?

Originally Posted by md95065 View Post
You really can't be too careful about the "in network" thing. I got caught out by this a couple of years ago when I had some minor surgery - the hospital, the surgeon and the anaesthetist were all "in network" but it turned out that the "physician assistant" who worked in the surgeon's office, and who I saw for one completely unnecessary 10 minute appointment where she explained to me some (but not all) of the the things that the surgeon had already told me, was, amazingly enough, not "in network" so I ended up with an unexpected bill ...
Aye, we had something similar but just as bizarre with the missus. She had some blood work done for a test, the lab in the hospital was in network but busy, so it was stored for a couple hours in the next office, which was a blood storage company, who weren't in network, that was a fun surprise :/
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Old Jul 18th 2013, 1:27 am
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Default Re: Healthcare - Is this normal?

Originally Posted by md95065 View Post
You really can't be too careful about the "in network" thing. I got caught out by this a couple of years ago when I had some minor surgery - the hospital, the surgeon and the anaesthetist were all "in network" but it turned out that the "physician assistant" who worked in the surgeon's office, and who I saw for one completely unnecessary 10 minute appointment where she explained to me some (but not all) of the the things that the surgeon had already told me, was, amazingly enough, not "in network" so I ended up with an unexpected bill ...
Similar happened to my husband. On another occasion he went to the ER...just before he was about to leave the doctor said his attending would like to introduce himself. The attending doctor wasn't in network.
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Old Jul 18th 2013, 2:46 pm
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Default Re: Healthcare - Is this normal?

Originally Posted by Bob View Post
Aye, we had something similar but just as bizarre with the missus. She had some blood work done for a test, the lab in the hospital was in network but busy, so it was stored for a couple hours in the next office, which was a blood storage company, who weren't in network, that was a fun surprise :/
What happens in this sort of scenario? I will have to make my first visit (since arriving) to the doctor in the few weeks. As I am on thyroxine I expect that they will want to do some blood tests, although I had some done just before leaving the UK and have brought the results with me. Is there any way I can ensure that I don't get hit with some hideous surprise cost?
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Old Jul 18th 2013, 3:05 pm
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Default Re: Healthcare - Is this normal?

Originally Posted by HartleyHare View Post
What happens in this sort of scenario? I will have to make my first visit (since arriving) to the doctor in the few weeks. As I am on thyroxine I expect that they will want to do some blood tests, although I had some done just before leaving the UK and have brought the results with me. Is there any way I can ensure that I don't get hit with some hideous surprise cost?
You get a bill and you pay it. The insurance will pay a smaller portion of it for being out of network.

As for surprise costs, no, it's a jungle out there.
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Old Jul 18th 2013, 3:14 pm
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Default Re: Healthcare - Is this normal?

Originally Posted by HartleyHare View Post
What happens in this sort of scenario? I will have to make my first visit (since arriving) to the doctor in the few weeks. As I am on thyroxine I expect that they will want to do some blood tests, although I had some done just before leaving the UK and have brought the results with me. Is there any way I can ensure that I don't get hit with some hideous surprise cost?
In advance make sure you know which labs are "in network" and go to of them. And if the doctor's office itself has a lab, make sure that is covered too. To me, one's aim should be to minimize the chances of being exposed to this nonsense, but in my experience there's no way fully do do so.
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Old Jul 18th 2013, 3:24 pm
  #21  
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Default Re: Healthcare - Is this normal?

Originally Posted by Giantaxe View Post
In advance make sure you know which labs are "in network" and go to of them. And if the doctor's office itself has a lab, make sure that is covered too. To me, one's aim should be to minimize the chances of being exposed to this nonsense, but in my experience there's no way fully do do so.
Have some business cards printed to hand out to everyone you meet, with the wording: "I'm not talking to you if you're out of network".
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Old Jul 18th 2013, 4:14 pm
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Default Re: Healthcare - Is this normal?

Originally Posted by HartleyHare View Post
What happens in this sort of scenario? I will have to make my first visit (since arriving) to the doctor in the few weeks. As I am on thyroxine I expect that they will want to do some blood tests, although I had some done just before leaving the UK and have brought the results with me. Is there any way I can ensure that I don't get hit with some hideous surprise cost?
I'm sure you know this but be careful with the dispensing of thyroxine. Due to the very tight titration, if you are on one brand (e.g. Synthroid) you should stick to it rather than getting the generic du jour. In the US you should ask the Dr to write dispense as written so you can stick with the particular brand that works for you. This may mean slightly higher pharmacy charges but it should be worth it for better thyroid control.
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Old Jul 18th 2013, 6:15 pm
  #23  
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Default Re: Healthcare - Is this normal?

Originally Posted by Pulaski View Post
Have some business cards printed to hand out to everyone you meet, with the wording: "I'm not talking to you if you're out of network".
Yes, was thinking of having a huge sign round my neck saying something similar when I finally go
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Old Jul 18th 2013, 6:17 pm
  #24  
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Default Re: Healthcare - Is this normal?

Originally Posted by sir_eccles View Post
I'm sure you know this but be careful with the dispensing of thyroxine. Due to the very tight titration, if you are on one brand (e.g. Synthroid) you should stick to it rather than getting the generic du jour. In the US you should ask the Dr to write dispense as written so you can stick with the particular brand that works for you. This may mean slightly higher pharmacy charges but it should be worth it for better thyroid control.
Thanks, I have read something a while back warning about the generic supplies. I will take mine with me when I go so that there can be no confusion as to which brand I'm on.
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Old Jul 20th 2013, 2:22 am
  #25  
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Default Re: Healthcare - Is this normal?

Originally Posted by Pulaski View Post
Have some business cards printed to hand out to everyone you meet, with the wording: "I'm not talking to you if you're out of network".
I love this advice lol. Filed under 'things I'd wish I'd known/ understood when we got here 6 years ago!
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Old Jul 20th 2013, 2:26 am
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Default Re: Healthcare - Is this normal?

Originally Posted by Jerseygirl View Post
I honestly think they try it on...in the hope you won't notice or will get fed up with all the hassle and pay up.
I had something similar with a dental bill. I saw a dentist for a root canal in 2009 and paid a large chunk of change at the time that the dentist said was my bill. In 2011 I started to get new bills for this period claiming I owed several hundred more. I dug out all the paperwork, and rang Cigna who were the insurers and Cigna said I did NOT OWE ANY MORE, AND HAD IN FACT PAID MORE THAN I SHOULD HAVE ALREADY. It took about 3 months to get a refund from the cretins. And I wouldnt have known unless Their billing system didn't go haywire and send me some new imaginary bill
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Old Jul 20th 2013, 3:37 am
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Default Re: Healthcare - Is this normal?

I found it near impossible at times to keep track of who was and wasn't in network.

I went to my GP office once and he wasn't there, so saw another doctor who worked in the practice, no idea he wasn't in network, and ended up paying a couple hundred bucks.

Best thing was when the insurance company decided after having originally approved a hospital stay, not to pay the final bill, which was 32,000, claiming it was not covered.

It got to the point it was either sue them, or go bankrupt so I just went bankrupt as a lawsuit would have cost far too much, and no guarantee of winning.

Never assume the insurance company will pay.
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Old Jul 20th 2013, 7:11 am
  #28  
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Default Re: Healthcare - Is this normal?

My husband had to go to the emergency room a few years ago. My insurance that I was on at the time said emergency visits were covered 100% after the $50 co pay. I got a bill from the hospital saying that the doctor was not in network. I called the insurance company and said that emergency rooms are supposed to be covered and that the hospital was in network It took nearly a year of going back and forth between the hospital billing department(who I got to know pretty well and they thought it was ridiculous and just kept deferring the account for several months) and my insurance company( They aren't even around anymore) I refused to pay an extra dime. They finally agreed to pay the bill.
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Old Jul 20th 2013, 12:08 pm
  #29  
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Default Re: Healthcare - Is this normal?

Originally Posted by Pulaski View Post
Have some business cards printed to hand out to everyone you meet, with the wording: "I'm not talking to you if you're out of network".
When I went into hospital to have my twins last year, I wrote at the very top of my 'birth plan' that, barring an emergency, I had United Healthcare insurance and did not want to see anyone who wasn't in network.

The nurses claimed to understand and I'm not sure how many people in the hospital were not in network but I managed a four day (uncomplicated) stay with no surprises other than a final bill of $71000 (yikes). The best bit was "your responsibility is $200"
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