Emergency benefits vs out-of-network
Mar. 16th, 2012 02:19 pm![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
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russian_america- Went to emergency room
- Doctor did surgery
- Doctor scheduled follow-up
- Doctor is out-of-network
- Insurance covers emergency
- Insurance wants to handle follow-up as out-of-network
- Insurance does not want to handle follow-up as part of an emergency process
- I see two options:
1. handle follow-up as an out-of-network visit to doctor's office
2. handle follow-up as an emergency coverage
How to make insurance to process emergency follow-ups as part of emergency procedures?
My reason is that I could not choose the doctor in emergency room, and now I'm forced into accepting all out-of-network costs. Sounds like Catch-22. Follow-ups should be treated as part of emergency procedures I think.
Well, I can definitely go to emergency room again and let insurance cover second visit, but it does not make whole lot of sense to put all that extra financial burden associated with the word "emergency" on insurance when just doctor's follow-up should suffice.
Also I can go to in-network doctor for follow-up, but if something goes wrong, both doctors will point fingers to each other...
Any ideas?
Update: A call to the doctor's office revealed that the first follow-up is considered a part of the emergency procedures at no additional charge.
- Doctor did surgery
- Doctor scheduled follow-up
- Doctor is out-of-network
- Insurance covers emergency
- Insurance wants to handle follow-up as out-of-network
- Insurance does not want to handle follow-up as part of an emergency process
- I see two options:
1. handle follow-up as an out-of-network visit to doctor's office
2. handle follow-up as an emergency coverage
How to make insurance to process emergency follow-ups as part of emergency procedures?
My reason is that I could not choose the doctor in emergency room, and now I'm forced into accepting all out-of-network costs. Sounds like Catch-22. Follow-ups should be treated as part of emergency procedures I think.
Well, I can definitely go to emergency room again and let insurance cover second visit, but it does not make whole lot of sense to put all that extra financial burden associated with the word "emergency" on insurance when just doctor's follow-up should suffice.
Also I can go to in-network doctor for follow-up, but if something goes wrong, both doctors will point fingers to each other...
Any ideas?
Update: A call to the doctor's office revealed that the first follow-up is considered a part of the emergency procedures at no additional charge.
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no subject
Date: 2012-03-16 06:34 pm (UTC)no subject
Date: 2012-03-16 06:34 pm (UTC)Мне кажется, это стандартный выход в таких ситуациях.
no subject
Date: 2012-03-16 06:36 pm (UTC)I think that's your only realistic option unless you want to wage a world war 3 with your insurance company.
no subject
Date: 2012-03-16 07:24 pm (UTC)emergency is over
no subject
Date: 2012-03-16 07:03 pm (UTC)no subject
Date: 2012-03-16 08:05 pm (UTC)period
no subject
Date: 2012-03-16 08:30 pm (UTC)Вы у своей страховки проверте что это так
no subject
Date: 2012-03-16 11:13 pm (UTC)Прошлым летом удалили мне апендицит, куча врачей была не в сети, но так как попал в госпиталь через ER, то страховка оплатила все сервисы - анестезиологов, хирурга, оператора хирургического девайса, палату, и пр. Из 40 тыщ заплатил только 100 за день в госпитале и 500 как годовой дедактибл.
Черед две недели ходил в офис хирурга показать как зажило, ничего не платил.