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Newly1
I love my baby boy!
Member since 6/08 2804 total posts
Name:
H
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Random Insurance Question...
Anyone know...
is it possible for your OBGYN to be covered under your insurance but the hospital she delivers through NOT be covered? I know for a fact my OB is covered by my insurance, and unfortunately I just had to get a D&C in the hosp. she delivers out of, and when i asked they told me not to worry about my insurance, so i am not EXPECTING a bill...but you never know
PROBLEM IS...
I do not see this hospital on the list of participating hospitals with my insurance. Just wondering if this has happened to anyone, i will make sure before i become PG again...but i really hope i can stay with my doc. b/c i like her and feel comfortable with her. She dosnt deliver anywhere else, and neither does anyone else in her practice...so i would assume it would be covered but who knows? Has anyone had a problem like this before??
TIA!!!
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Posted 4/14/09 1:38 PM  |
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pandaworm
LIF Adult
Member since 8/08 1125 total posts
Name:
bethany
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Re: Random Insurance Question...
i know a coworker had a problem when her daughter was born. her doctor was covered but her daughter had to go to the NICU for a while and not all of the doctors that saw her there were covered so she got a pretty heafty bill from them. i know she was able to argue her way out of it, but i'm not sure of the details...
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| Posted 4/14/09 2:34 PM |
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LSP2005
Bunny kisses are so cute!
Member since 5/05 19461 total posts
Name:
L
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Re: Random Insurance Question...
This happened to me, with the anesthesiologist who assisted during my c/s for DS. I argued with the insurance co that there was no way for me to choose an anesthesiologist - you just take who ever is on call. It was an emergency c/s at that. I had to pay up to my deductable but they elminated the out of network charges. The hospital I delivered at is considered in-network for me. It was really a PIA.
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| Posted 4/14/09 2:39 PM |
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SweetCin
My green-eyed boy
Member since 5/05 13499 total posts
Name:
Cin
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Re: Random Insurance Question...
Posted by LSP2005
This happened to me, with the anesthesiologist who assisted during my c/s for DS. I argued with the insurance co that there was no way for me to choose an anesthesiologist - you just take who ever is on call. It was an emergency c/s at that. I had to pay up to my deductable but they elminated the out of network charges. The hospital I delivered at is considered in-network for me. It was really a PIA.
Same exact thing happened to me w/ our anestesiologist. None at the hospital take the insurance we have (B/C, BS) & so we got a bill for about 8k!!! Thankfully after many letters & calls, the insurance co. did take care of it. It was an emergency CS as well.
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| Posted 4/14/09 3:00 PM |
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shapla79
Where Does The Time Go?
Member since 11/07 4619 total posts
Name:
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Re: Random Insurance Question...
Posted by pandaworm
i know a coworker had a problem when her daughter was born. her doctor was covered but her daughter had to go to the NICU for a while and not all of the doctors that saw her there were covered so she got a pretty heafty bill from them. i know she was able to argue her way out of it, but i'm not sure of the details...
This happened to us and we successfully argued that it was not possible to choose a NICU doctor- you take whoever's working/on call. Everything was covered, except for the deductible for my hospital stay.
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| Posted 4/14/09 3:07 PM |
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BeachMom
Love my 4 kiddos!
Member since 11/08 8346 total posts
Name:
Kristie
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Re: Random Insurance Question...
The problem with the hospitals is that i dont think it really matters if the hospital is covered or not, it's the dr that you see there. When i went to the ER at a totally covered hospital. I got 5 seperate bills from each dr and sonographer that i saw because even though the hospital takes my insurance the dr's dont.
If your dr performed the procedure than it should be covered just like any other procedure done by your dr.
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| Posted 4/14/09 3:11 PM |
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Aga
hello baby Albert
Member since 9/05 7750 total posts
Name:
Aga
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Re: Random Insurance Question...
Posted by SweetCin
Posted by LSP2005
This happened to me, with the anesthesiologist who assisted during my c/s for DS. I argued with the insurance co that there was no way for me to choose an anesthesiologist - you just take who ever is on call. It was an emergency c/s at that. I had to pay up to my deductable but they elminated the out of network charges. The hospital I delivered at is considered in-network for me. It was really a PIA.
Same exact thing happened to me w/ our anestesiologist. None at the hospital take the insurance we have (B/C, BS) & so we got a bill for about 8k!!! Thankfully after many letters & calls, the insurance co. did take care of it. It was an emergency CS as well.
thats a common problem with most anesthesiologists! I had the same problem, my insurance covered half and I had to pay the other half...
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| Posted 4/14/09 3:21 PM |
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pandaworm
LIF Adult
Member since 8/08 1125 total posts
Name:
bethany
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Re: Random Insurance Question...
also, if you get a bill, make sure you call your insurance company. half the time they don't send the bills to them and then you're stuck thinking you have to pay. this happened with an ER visit i had last year. i kept getting the same bill and had to send it to the insurance company 5 times, but they eventually took care of it.
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| Posted 4/14/09 4:04 PM |
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lisalisa27
LIF Infant
Member since 8/07 188 total posts
Name:
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Re: Random Insurance Question...
This really should not be happening the insurance company is supposed to work out a case rate the with non par doctors to cover payment. But it is important to go to a par hospital because usually all fees would be paid under the payment to the hosptial for the docs, anesth, and so forth. I know that does not happen all the time but your insurance company should really be working a rate with the hospital. I work for a Health care insurance company and this is what we do. Also many plans not all have a clause in their benefit that states you cannot bill the member for non par services. But of course many docs bill anyway.
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| Posted 4/14/09 10:28 PM |
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