Not PR, insurance ?

musiscout

Maybe someone on this lovely board is in the medical billing/ insurance industry. I had a procedure done in July at my doctors office. The receptionist took my insurance card and said that was all I needed to do. Am I ignorant to assume then that the anestesiologist should have taken my insurance then too? It ends up that he doesn't accept my insurance. Shouldn't I have been told that before the procedure? So now I have to pay a $200 deductible for out of network providers. I just looked through the website and figured this out. I'm calling the anestesiologist's office and my doctors office. Is there anything I can do or am I stuck paying the $200?

TIA

ccorso

Really it is not up to the office...it all has to do with your insurance.  So, more than likely you are paying the $200.  This happens all of the time with surgeries and other procedures that use more than one medical provider.  Unfortunately, it is on us to make sure everyone is covered.  --oh I am a HR manager that deals with insurance.  

DS2507

I work as an insurance specialist at a hospital and we see this a lot. The anestesiologists that we use for surgery are contracted independently from the hospital so many times they aren't in network with the patient's insurance. It's insane in my opinion and I definitely never knew about this until I started working in insurance.

More than likely, you will be stuck with the $200 but I would give it a try with the doctor's office. But if I had to guess, they will tell you that you are responsible for knowing your policy and checking these things beforehand "Ultimately insurance is the patient's responsibility."