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another insurance question-anesthesiologist not covered

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ladybug8
LIF Adult

Member since 3/07

2660 total posts

Name:

another insurance question-anesthesiologist not covered

My husband was given a referral (with a participating doctor) for a procedure.
We are now faced with a bill for $950 for the anesthesiologist. The total cost is $2,000 and the insurance company sent us a check for $1,050 and a note saying we are responsible for the rest. (We still have the check) So, when my husband went to the participating doctor on the day of the procedure he should have asked if the anesthesiologist was a participating doctor also?

Posted 12/29/08 7:50 PM
 

LIgrlatheart
LIF Adolescent

Member since 7/06

638 total posts

Name:
christi

Re: another insurance question-anesthesiologist not covered

usually when you get a situation like that you send the check to the main doctor (you sign some paperwork 90% of the time sayign that any payment made to you directly should be fwded to the dr).. like i had a colonoscopy and the paperwork was worded like that..
and most likely you dont' owe anything but your copay and/or applicable deductible


Posted 12/29/08 7:58 PM
 

MsMBV
:P

Member since 5/05

28602 total posts

Name:
Me

Re: another insurance question-anesthesiologist not covered

This happens a lot with anethesiology, and there is one group on LI in particular that tries to bill for services not required to be paid by the patient. Most of the time if the Dr that is performing the procedure is a participating Dr, and/or a referral was obtained, then it should be covered. Most of the time you, as the patient, do not have the choice of anethesiologists, and cannot pre-certify them.

Posted 12/29/08 8:19 PM
 

lullabella
LIF Adult

Member since 5/05

2246 total posts

Name:

Re: another insurance question-anesthesiologist not covered

This should be covered under a wrap benefit... Call your insurance company.

Posted 12/29/08 9:11 PM
 

BabyBoy
is Skylar Elizabeth

Member since 5/05

4189 total posts

Name:
Tom

Re: another insurance question-anesthesiologist not covered

Both your dr and the place you went should of noticed what type of insurance you have.

A, you dr should of advise you that you would of have to come out of pocket. OR sent you to a place that would cover it.

B, the office you went to when they took your information that you are not fully insured for the procedure.

As an above poster say, most companies don't cover certain procedures.

The prime example i know is for dental, i can't get knocked out as my company only allows novacian. (i prefer local anestha anyway.)

Posted 12/29/08 9:17 PM
 

MelBobby
LIF Infant

Member since 11/08

292 total posts

Name:
Mel

Re: another insurance question-anesthesiologist not covered

This happened to me too!! I called my insurance company right away. I said I was not aware that the anesthesiologist would not be covered. They said ok disregard the bill... that was that!!

Posted 12/29/08 9:29 PM
 

dm24angel
Happiness

Member since 5/05

34581 total posts

Name:
Donna

Re: another insurance question-anesthesiologist not covered

NO, Call the Anesthesologist , ask if they will accept the check as payment in full...send to them. If they say yes, fine. If they say no, CALL you insurance ASAP and tell them that they are balance billing you, you had no choice.

99,9% of Anesthologists do not take insurance.

your insurance will cover it.

If they dont, like I posted before, FM me I will get it covered for you.

Posted 12/29/08 9:31 PM
 

Mommy2Boys
My Boys!!!!

Member since 6/06

14437 total posts

Name:
C

Re: another insurance question-anesthesiologist not covered

Posted by ladybug8

My husband was given a referral (with a participating doctor) for a procedure.
We are now faced with a bill for $950 for the anesthesiologist. The total cost is $2,000 and the insurance company sent us a check for $1,050 and a note saying we are responsible for the rest. (We still have the check) So, when my husband went to the participating doctor on the day of the procedure he should have asked if the anesthesiologist was a participating doctor also?




OMG...this just happened to me today. I got a check in the mail fron GHI Chat Icon so I knew right away something was wrong. I had hernia surgery last month and my surgeon was a GHI participant, apparently the anesthesiologist was not. I said well I only met the guy about 2 min. before surgery...I didnt think to ask him "are you a GHI participant" Chat Icon Chat Icon Chat Icon I would think if the surgeon knew my insurance was GHI and they ask for your insurance info. 100 times I would have had an anesthesiologist who participated. Guessed wrong Chat Icon

Anyhow, they sent me a check and said I can ask him if he will accept that as full payment for I have to pay the balance of $1k Chat Icon Chat Icon Chat Icon If he doesnt accept the GHI payment I am going to tell him he'll be getting $10/mo. from me for the next 10 yrs. (as long as you make payments, drs cannot turn you over to a credit collection agency). I am so angry!!!

Posted 12/29/08 9:58 PM
 

ladybug8
LIF Adult

Member since 3/07

2660 total posts

Name:

Re: another insurance question-anesthesiologist not covered

Thanks everyone for the advice! I really appreciate it. I will get on hubby's case to call tomorrow.

Posted 12/29/08 10:13 PM
 
 

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