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Finally fix in the works for in network hospitals with out of network doctors.


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2012 Feb 28, 10:03pm   7,276 views  11 comments

by RC2006   ➕follow (2)   💰tip   ignore  

I have been hit by this several times, I have a PPO and especially with the birth of my last three sons every time there was one doctor that I had no control over that was out of network. At least 50% of my health costs have been from hospitals that are in network but have a doctor that is out of network providing care the last 5 years.

Hope this passes.

http://www.scpr.org/programs/airtalk/2012/02/28/22703/sb-1373

Comments 1 - 11 of 11        Search these comments

1   elliemae   2012 Feb 29, 12:29am  

The article says that patients are provided with the information IF THEY ASK FOR IT. So, patients and/or family members who aren't responsive or don't ask will not be provided with this info.

The article doesn't say how the law will address those situations where a specialist is needed but there is no in-network MD to provide it in a timely manner.

Most physicians don't work for the hosptial - they are independent contractors and are either chosen on a rotation basis or are referred by the patient's primary doctor. It might be that they are the best man/woman for the job, or they're good friends or somehow affiliated with the primary MD. It happens more often than you'd imagine.

2   Patrick   2012 Feb 29, 3:50am  

Lieu introduced SB 1373, which would require medical providers and hospitals to disclose treatment costs associated with health care services and procedures, in hopes of avoiding sticker shock by patients after the fact. According to Lieu’s office, the bill was written in response to an investigative report that found a number of patients were being billed for services they didn’t consent to and sometimes for services or providers that weren’t covered under their medical insurance.

Yes! I've been calling for this for years now. How can we help it pass?

3   Patrick   2012 Feb 29, 3:52am  

I guess that bill is just for Arizona.

It should be national law that you can't be billed unless you explicitly agreed to the exact amount of charges in advance. Maybe emergency room excepted.

4   RC2006   2012 Feb 29, 7:15am  

They need to pass a law that requires any doctor working at a hospital to accept the insurance rates that the hospital agreed to, if they don’t like it they can work elsewhere. There is no reason a person should go to an in-network hospital and not expect all services provided are also in-network. The way it is now it’s all a scam.

5   Danaseb   2012 Feb 29, 9:21am  

Considering stuff like this is legal in this country i find it amazing its still limping along; no pun intended.

Getting down to the brass tacks that we as a country are okay with raping profits from sick people; most services are required to get estimates or risk having little legal standing to get paid. It should be no different. If it wasn't for bankruptcy this country would have ceased up from having 70% of its population incarcerated for debts.

6   GRACE123   2012 Mar 1, 9:32pm  

I went for my annual check up at a women's clinic in Los Gatos. My doctor wanted me to get a blood test for Vitamin D. The lab is inside the clinic so I assumed I was in network. I was shocked when I got a bill for $470 for the test. Apparently Hunter Labs does not have a contract with Blue Shield of California.

7   zzyzzx   2012 Mar 2, 12:07am  

I also agree that this is a big scam and needs to be delt with.

8   elliemae   2012 Mar 2, 12:34am  

grace 123, if this is an active issue tell them you'll pay 1/3 of it or make teeny payments forever. it's not worth it for them to turn you into collections.

i have an illness that requires labs, the billed amount is $1,000 and the amount they accept in full from my insurance is $150.

9   TPB   2012 Mar 7, 1:55am  


Lieu introduced SB 1373, which would require medical providers and hospitals to disclose treatment costs associated with health care services and procedures, in hopes of avoiding sticker shock by patients after the fact. According to Lieu’s office, the bill was written in response to an investigative report that found a number of patients were being billed for services they didn’t consent to and sometimes for services or providers that weren’t covered under their medical insurance.

Yes! I've been calling for this for years now. How can we help it pass?

By repealing Obama care and demanding they go back to the drawing board, and work on a national health care system that is TAX based, and nothing is outsourced. If the Democrats can't get the GOP to pass it, then put it up to Vote by the Nation's Voters. In all reality, legislation such as this, should be decided by the people and not Lobby Clowns in Washington.

10   elliemae   2012 Mar 7, 5:24pm  

TPB says

In all reality, legislation such as this, should be decided by the people and not Lobby Clowns in Washington.

Hell, our president isn't even elected by the people. If he were, Bush never would have made it.

11   TPB   2012 Mar 7, 11:17pm  

elliemae says

Hell, our president isn't even elected by the people. If he were, Bush never would have made it.

Are we still on that? Gore lost because I voted Nader. And I wish I personally did more to convince the Liberals what a lost cause Al Gore was, to join in me in my sensible choice. Al Gore cost Ralph Nader the presidency.

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