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?

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

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.

Re: another insurance question-anesthesiologist not covered

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

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.)

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!!

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.

Re: another insurance question-anesthesiologist not covered

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.