Hellobee Boards

This happened to my sister and she did fight it and was able to have the charge removed. In my opinion, they should notify you beforehand of things like this. Granted, there may be nothing you can do if there are no in-network providers, but you should be given the choice to make an informed decision. I think it is worth taking up with the hospital, if nothing else maybe you can get it knocked down a bit.

You may have more leverage if you can pay the agreed upon amount in cash/check as opposed to credit upfront instead of a long term payment plan because then they will know they are getting payment from you and avoiding their credit processing fees?

Wow, I have no advice, but I just assumed anything happening at my in-network hospital was also in-network. I never would have thought to ask that question!

Have you actually contacted the insurance company regarding the processing of the bill? I had something similar recently where a lab was processed as out of network. When I called to question it, the insurance acknowledged that I can't control where my physician sends my blood and the claim was reprocessed as in network based on the referring physician being in network. It was a simple 5-10 minute call without having to go through an appeal process.

I did after my d&c it was so frustrating.

I'm currently dealing with this too. Exact same scenario - did my due diligence with my insurance company prior to my c-section, hospital and OB in-network, etc. I contacted my insurance company first and was told they wouldn't pay more because the anesthesiologist was out-of-network, despite being told prior to my surgery that there would be no out of pocket expenses and me having no control of anesthesiologist choice. They told me to contact the doctor. I contacted the anesthesiologist's office and was told to file an appeal with my insurance company. I just sent my appeal yesterday. It turns out many states have laws that protect consumers in the case of an in-network facility providing an out-of-network doctor over which the patient has no choice. In my state, I'm entitled to remediation between the physician and my insurance company if the balance billed to me is over $1,000 (which mine is). I live in a very conservative state - if you live somewhere more liberal-leaning your laws may provide better protection. Try googling "consumer protection balance bill out of network hospital provider (insert your state)." Wall me if you want more specific details about what I've found out, what I've written in my insurance appeal, etc.

That sucks. Unfortunately we got saddled with 80/20 for maternity care and delivery. So I was expecting a big bill. Then I had 3 hospital stays before birth and an unexpected c section so we are paying about $4,000 total. Wasn't expecting that much.

Insurance sucks.

@thismustbetheplace: @owlmom: PLEASE read this. I have been through this several times, as I have a genetic proclivity to colon cancer (yay) and get colonoscopies every other year and have had an epidural when having my LO. Anesthesiologists are almost ALWAYS "out of network". Literally almost always. For what they do, they have no incentive to hire employees to code bills for insurance companies, so they don't join any networks.

So you have to call your insurance company and invoke the "ologist" rule and say that you didn't have the choice of using an in network anesthesiologist. Then the insurance company is required to negotiate with the anesthesiologist and only charge you for an in network anesthesiologist.

Your insurance company won't do this automatically because they want you to pay full price. Neither the anesthesiologist nor the insurance company will tell you this. They collect a lot of $$ this way.

If they rule against you, file a dispute.

@Anagram: thank you so much! And I'm sorry you have to deal with this frequently.