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Is it a doctors obligation to tell me about hospital insuran

 
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amother




Firebrick


Post  Mon, Feb 04 2019, 6:48 pm
Basically my insurance has tier 1 and tier 2. In tier 1, I have to pay $150 copay for outpatient surgery, no deductible. My son had outpatient surgery. I got a hospital bill for $2000

Called insurance, who said the hospital I used was on tier 2, which is a $1500 deductible plus 500 copay or coinsurance, I forgot

Dr gave me choice of 2 hospitals to do the surgery. One had appointment within the month. The other had appointment only a month after the 1st hospital. I asked the secretary who called me if both hospitals take my insurance and she said yes. I thought that meant both are on tier 1. I definitely should've asked, but my question is, was it their obligation, having my insurance right in front of them, to tell me that and maybe save me $1850? (Idk if I wouldve done it in other hospital, which is on tier 1, and waited the extra month, but I mightve...) if it is their obligation, what can I do now, that I have this $1850 that I didnt know I needed to pay
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allthingsblue




 
 
 


Post  Mon, Feb 04 2019, 6:50 pm
I doubt it's their obligation. It's an unfortunate mistake and next time your best option is to doublecheck yourself with your insurance whether that hospital is accepted and at what level.
I'm sorry; I know it's frustrating! We got hit with two $1000+ bills due to insurance issues so I feel ya!
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Sebastian




 
 
 


Post  Mon, Feb 04 2019, 6:54 pm
No it s not their obligation. I'm sorry OP it stinks.
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amother




Pewter


Post  Mon, Feb 04 2019, 6:54 pm
I don't know if the doctors office even has access to that much detail about your plan. I'm sorry you got stuck with this. In the future, ask each provider separately.
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octopus




 
 
 


Post  Mon, Feb 04 2019, 6:56 pm
As far as I know, it's not their responsibility. It does stink! We are always calling the dedicated # on the back of the insurance card to talk to an insurance person to check if procedures are covered under insurance. Or we check online for hospitals and doctors.
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amother




Navy


Post  Mon, Feb 04 2019, 7:04 pm
Doctors usually warn people to make sure that the services they are recommending are covered by their insurance before proceeding. It falls on the patient to do that. Even then, insurance can be so tricky because there are insurance exclusions and the person you might be talking to at the insurance company has no incentive to actually be accurate or trained well enough to even give you the right answer. It's just a job to them and at the end of the day, they still get paid no matter what they tell you. BTDT situation.
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amother




Gray


Post  Mon, Feb 04 2019, 9:32 pm
Within every insurance ( Oxford, blue cross etc) there are dozens of diff. Plans each coveringv different expenses, deductible eyc

Does anyone seriously expect a dr to keep track of the details of every plan and which cover what at every hospital????

If u don't know details of ur OWN insurance why on earth would u expect the dr to???

What What


Last edited by amother on Tue, Feb 05 2019, 11:34 am; edited 1 time in total
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amother




Cerulean


Post  Mon, Feb 04 2019, 9:35 pm
Delete

Last edited by amother on Mon, Feb 11 2019, 12:16 pm; edited 1 time in total
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amother




Firebrick


Post  Mon, Feb 04 2019, 9:43 pm
mig100 wrote:
Within every insurance ( Oxford, blue cross etc) there are dozens of diff. Plans each coveringv different expenses, deductible eyc

Does anyone seriously expect a dr to keep track of the details of every plan and which cover what at every hospital????

If u don't know details of ur OWN insurance why on earth would u expect the dr to???

What What


No need to answer this so nastily! I bh dont usually do anything other than regular dr visits, I did something stupid with this, my son needed a last-minute surgery and I asked the dr if the hospital takes my insurance... im left with a bill of $1850 more than I thought, and im trying to figure this out. Everyone before you answered the same thing you did, though in a nicer way. So I guess I can just say thanks for making this harder for me and making me feel like an idiot
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amother




Pewter


Post  Mon, Feb 04 2019, 9:45 pm
amother wrote:
No need to answer this so nastily! I bh dont usually do anything other than regular dr visits, I did something stupid with this, my son needed a last-minute surgery and I asked the dr if the hospital takes my insurance... im left with a bill of $1850 more than I thought, and im trying to figure this out. Everyone before you answered the same thing you did, though in a nicer way. So I guess I can just say thanks for making this harder for me and making me feel like an idiot


You can call the hospital and let them know this was unexpected. Usually they will work out a payment plan with you or even reduce the charges. It's a very normal thing to ask about, so don't feel self conscious.
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amother




Firebrick


Post  Mon, Feb 04 2019, 9:47 pm
smileforamile wrote:
Not sure if it applies to this situation, but doesn't hurt to post.

https://www.dfs.ny.gov/consumer/hprotection.htm


Tysm! Im actually in NJ, so I doubt this can help but thanks
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