Out of network Hospitalist charges

Good for you that you argued your case, but that's such an infuriating story! My daughter was seen in the emergency room at University of Michigan Hospital and we went through the same thing! They said the ER doc was not in network even though U of MI Hospital is in network with our Blue Cross, and you don't get to pick your ER doc! Sheesh! We argued it and got our charges reduced too. I hate the US health care system!!!!

Gumby- I hate the US healthcare system too! It is sad that we have to fight for what is right when something like this should never happen. If a Dr. is not in network then they should not work in or for the hospital, period.

beave- I hope you complained and got it written off too!

Petitarte- Are you familiar with a hospitalist? You do not get a choice. If you go to the hospital and are admitted, this group of Doctors manage your care, regardless of your preference. They are hired by the hospital therefore, if your hospital is the preferred provider for your insurance then the hospitalist SHOULD accept that insurance because they are the ONLY hospitalist group to work at that particular hospital. Luckily the hospital agreed because I got the hospitalist charges taken off:) Victory!

Take care!

In NY in an emergency situation the insurance must pay the charges regardless of network coverage however once the emergency situation has passed you as the patient are responsible to make sure that the doctors treating you accept your insurance and you can refuse treatment and request another doctor if they don't. You can argue that a lot of times when someone goes to the ER it is also not a true emergency and therefore you can refuse treatment until an in-network doctor is available. I know that I personally have gone to the ER plenty of times for Crohns issues and i'm uncomfortable and miserable but it isn't life and death unlike when I've gone for anaphalaxis.

You have the right to refuse the care of anyone who does not take your insurance including the hospitalist. When I go to the ER I always call either my GI or internist to let them know that I'm going. I have refused tests and treatments recommended by the ER doc and told them if they have a problem they should speak to my doctor.

Wow. That's not good enough, on multiple levels. I'm so sorry you had to go through that, pmedic.

At the very least, they should have told you on admission, instead of waiting for two days! Grrrrrr.

:-0 No way.

Horrified.

Speechless.

:-0

Ivy- Exactly! I was in so much pain from the pancreatitis and even missed that they substituted Zosyn for Cipro. This substitution caused such severe diarrhea I went into metabolic acidosis because the nurses did not follow Dr. orders for the IV rate so I dehyrdated fast. It was a very bad week. I was pretty unhappy with my hospital stay all around!

I was finally feeling well enough today to march myself down there to complain about the care and the bills. Today was a good day :)

Our local hospital has changed from having radiologists and anesthesiologists on staff to contracting w/"outside" anesthesiology and radiology groups and thus these two professions charge separately as well. Plus, of course, there is the charge for the hospital's space and equipment.

They've also gone to hospitalists. However, whether you have a hospitalist or not depends on your admitting doctor and whether he has opted to continue making hospital vists or opted to relinquish that duty to the hospitalists.

Their pronounced reasoning for these actions is cost savings and insurance reimbursements. What we actually see and experience is higher copays and the hospital constantly building outpatient clinics and doctor offices, even laboratores and imaging offices, in various areas around the county, especially the busy "high rent" districts such as near the big shopping mall, etc.

It is hard to swallow that they are so hard-pressed for money when we see all their buildings going up around the county.

Thank goodness you had enough knowledge of healthcare system to know you could fight those charges. Sadly many would have just accepted it and paid them.

Speaking of hospitals taking over towns. We have two in our area that are fighting each other. One is actually an insurer who is taking over a failing hospital system and the other is a grotesquely large university health system who in recent years have exploded in size & scope. My current GI is with the university system but due to the infighting and changes I will be forced to change to the hosp. system run by the insurance company. You are right US healthcare sucks, but I don't think the massive changes were well thought out. There -- I'm done ranting.

We all must remember to be our own advocates.

Pmedic -- my PCP even agrees with that when it comes to this particular hospital system. She even has trouble with them regarding her teenage daughter and was relieved when I told her it's not just her. I guess she thought maybe it was an isolated thing.

	VIEW IMAGE Posted 6/3/2012 9:25 PM (GMT -6)	VIEW IMAGEVIEW IMAGE
	Here in Canada, each of our provinces has its own form of Health Care, no one is left without some kind of coverage. I am pretty much an American Political junkie, and I just do not understand why there is so much descention among so many Americans when it comes to Health Care. Bottom line is, everyone needs it so why don't the politicians take a look at ours, England, etc. and see how we do it. It just seems that whenever I read posts from all of you, where you discuss your problems with your Health care system, it breaks my heart that so many of you are struggling especially when it comes to getting your necessary meds, and paying for a doctors appointment let alone having to pay for surgery, that is just unheard of here in Canada. A little off topic, but this has been on my mind for a while, so I wish you all good luck, my heart goes out to all of you in this terrible predicament.  When we go into Emergency, you are seen by the hospitalist of the day, and if you need a GI for instance, the hospitalist hands you over to the GI that is on for that day.  You go in, get treated, and never pay anything for the hospital stay, tests, medication or the doctor.  I really wish Americans could experience what we do in Canada, because having to deal with thinking about what things are going to cost is just added stress that you don't need.