Originally Posted By: Drew99GT
One of THE MOST IMPORTANT THINGS TO REMEMBER, having had 2 big surgeries as of now: Even if you're sitting there about 5 minutes away from anesthesia, you hopefully are at a hospital that is in your network, but make darn sure that every single service provider in the hospital that works on you is in network also. Seriously, when I had my appendicitis, the pathologist was out of network. Luckily, I whined enough to the insurance company and the pathologist's office and they billed the insurance company for the in network amount. My deductible amount went from about $250 to $5! Had it been for the actual surgeon, or anesthesia, it could have killed me. Thousands of people get taken to the bank when they get service at an in network hospital from an out of network provider. You'd think they'd check on these things but it's up to you to make certain.
That's good advice. When I was in a PPO, I always asked before any medical treatment.
They still bleeped up on a couple of occasions. In both cases when I gave the billing office the the name of the person I had asked and the date, they settled for in network rates and worked it out with my insurance company.