12.22.2020

It's Just the Coffee Talking - I read Congress is passing a law to stop 'surprise' medical bills from out of network providers... fingers crossed they dot their i's and cross their t's!

 

Last night I read a short news article that Congress is set to pass a law about 'unexpected medical bills'.  What it boils down to is when you choose a hospital and a doctor that is 'in' your network, so you know they are covered by your insurance plan... that hospital or doctor then uses other facilities or labs or healthcare workers not covered by your plan (and you have no idea they did, and have no say over the matter) and you end up with a 'surprise' bill after the fact that you are responsible for because they are not in the approved list for your particular plan.

If they pass this correctly, with no loopholes, then I'm thrilled!   When Mr. Coffee had spine surgery 2 years ago we learned first hand what a huge profitable mess this new way of billing is... 

Yes, you do your due diligence to make sure the doctor, the emergency room, the clinic, the hospital you choose is approved and covered by your plan.  But you have no way of knowing who THEY might use for their blood draws, lab work, x-rays, and other doctors/clinics involved in doing any of the work, glancing at a report and billing for it, etc.  

And that means you can get 'surprise' bills for lab work, x-rays, MRI's, nurses (yep, we found we billed individually for the NURSES - WTF?)...  and the bills come to you because they are 'not in network' even though you have no say and knowledge over who the clinic or doctor uses.  

We had 2 companies that apparently provided "remote" viewing of Mr. Coffee's spine surgery from their computers in California and Tennessee... what the heck?  We were billed for them (one was $16,000 a year AFTER SURGERY) and we had no idea they even existed. You can fight these charges and sometimes get them reduced approved but it's a long, long fight with multiple phone calls, paperwork and time....  

Hoping this law passes and plugs up profitable loopholes in which private companies 'buy' an emergency room but then employee all their own doctors, staff, labs and x-rays so the prices are jacked up and you have to pay more because THEY are out of network even though the hospital or clinic is officially IN your network. 

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Thanks for sharing morning coffee with me!