When you get a hospital step-in surgeon suddenly

IrishEyes

IrishEyes

Sharon
Location
Midwest
Does it occur to you to make sure he is covered by your health network?
I was just at the Blood lab this morning and had a conversation with the lab tech
brought on by my remaining puncture marks in my arm.
The conversation came round to the many different doctors I encountered and all wanting me do
follow ups with them.
She said that happened to her and she asked them right away "Is he covered by my insurance?"
She said the nurse was confused why she was asked that and told her he is your doctors associate.
The tech replied back, "I will not sign consent until I know he is covered by my insurance".
I have to admit, thinking back to the several doctors I encountered I never thought to ask that.
Has this ever occurred to you to be sure also?
 
That hasn't happened since I've been on a Medicare Advantage plan, but when I worked it did. The company had a plan requiring us to use doctors in their network. I made sure the surgeon was, but the day before surgery, the anesthesiologist called to go over allergies, other concerns, and I asked him if he was in my insurance company's network. I don't think he was going to bring that up. Turned out he was not, and another anesthesiologist had to be found. I never forgot that, and always check.
 
IrishEyes said:
Does it occur to you to make sure he is covered by your health network?
I was just at the Blood lab this morning and had a conversation with the lab tech
brought on by my remaining puncture marks in my arm.
The conversation came round to the many different doctors I encountered and all wanting me do
follow ups with them.
She said that happened to her and she asked them right away "Is he covered by my insurance?"
She said the nurse was confused why she was asked that and told her he is your doctors associate.
The tech replied back, "I will not sign consent until I know he is covered by my insurance".
I have to admit, thinking back to the several doctors I encountered I never thought to ask that.
Has this ever occurred to you to be sure also?
Click to expand...
That would never be a question, here in Canada, as every Doctor is a part of the Provincial medical care program in that Province. And of course, all citizens, and permanent Residents are ALSO covered by the Provincial health care program. That is why it's called a Universal care program.

JIMB>
 
MACKTEXAS said:
That hasn't happened since I've been on a Medicare Advantage plan, but when I worked it did. The company had a plan requiring us to use doctors in their network. I made sure the surgeon was, but the day before surgery, the anesthesiologist called to go over allergies, other concerns, and I asked him if he was in my insurance company's network. I don't think he was going to bring that up. Turned out he was not, and another anesthesiologist had to be found. I never forgot that, and always check.
Click to expand...
I am trying to wrack my brain remembering who and how many doctors had a dent in my care in those two days. Some I can't even
remember their names. I do have one of the major used Insurances in this area I am pretty sure I am good but... now I have that
ummm are you sure thing going on. You think that would be part of the job of the hospital wouldn't you? You are so drugged up and
sleep depredated how do you know up from down in there?
Thought I would post this so others are aware, I sure wasn't.
 
IrishEyes said:
I am trying to wrack my brain remembering who and how many doctors had a dent in my care in those two days.
Click to expand...
Yes, I understand. And suppose someone had a heart attack and went to the ER room, then out of the ER room into a regular room and various procedures had to be done by all sorts of providers. The patient would have no way to keep up with all that or ask questions.
IrishEyes said:
You think that would be part of the job of the hospital wouldn't you?
Click to expand...
But I don't think it is. Their focus is on care, and they may not (just as the surgeon in my case selected an anesthesiologist who was not in my network.)

That was the best part of having traditional Medicare and a supplement, which bypassed those in-network requirements. That was the main reason I preferred traditional Medicare, but the cost went up a huge amount each year on my supplement, until I finally decided to switch to an Advantage plan.

On Humana, if I see an out-of-network provider, it will still be covered, only I'll have a higher co-pay. I figure if I end up in that situation, I'll still come out cheaper since I will have saved those high supplement payments. If it doesn't work out that way, then I lose - it' a gamble I take, but life is full of many chances; we do the best we can.
 
StarSong said:
I'm with Kaiser Advantage. If an outside doctor or testing facility is used, that's because Kaiser contracts with them and orders it, therefore Kaiser picks up the tab. No worries for me.
Click to expand...
Thanks for that input - it relieves some concern. I did an AI inquiry and got the below response - and now I recall that a few years ago, "no balance billing" laws went into effect which apparently covers this very scenario, in addition to it's other provisions.


network.jpg
 
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