Surgeons using 'contracted' out of network surgical assistants

[Sosewsue61 3,185]

Be aware! My surgeon apparently used a contracted surgical assistant not affliated with the hospital and probably not in my insurance network and I will be billed for this. I was not verbally informed of this, I was told students might be observing. I suppose it could have been in the hospital fine print? The surgeon's office however never informed me.

There are three states that require insurance companies to cover these contracted assistants - Illinois, Kentucky, and Texas. That doesn't necessarily mean it will be at in-network policy coverage as they have not negotiated rates with your insurance company and you are liable for the bill/remainder within 30 days.

I called my surgeon's office and in the surgical notes it lists the person as a 'visitor'. WTH? Anyway the surgical coordinator had an emergency and will call me back to discuss this.

I will keep you posted.

[sleevedshereen 524]

SAME THING HAPPENED TO ME! HOSPITAL WAS IN NETWORK AND SURGEON AND ANESTHESIOLOGIST TOO but because the assistant to the surgeon was out of network they billed a crazy amount and want me to pay! They lied to me. They said I had a max out of pocket of 5,000 for the year and I only had to pay 3,000 out of pocket for my surgery. My insurance company is filing an appeal and said I would most likely not have to pay it since the doctor's office lied to me and I have the paperwork to prove it. I let my surgeon and his office have an ear full. I don't understand how they can do that. The coordinator said they verified benefits and they are in the network. They should tell us that their assistant in surgery is Out of network but they didn't. So messed up. I was in tears when I saw my portion was 42k because they were out of network. I threatened to sue my doctor and he said that they would make sure I don't have to pay it and they were sorry for any miscommunication....miscommunication?! You mean misleading, lies! I was freaking out. Very unethical to not tell the patient that someone in the surgery room is out of network. No w I know for future surgeries, verify who will be in the room, get a list, call my insurance company directly and verify benefits and each person who will be in the surgery room prior to having surgery and DO NOT trust the doctor's office when they said it's in network or what my out of pocket cost will be, etc.

Edited November 14, 2017 by sleevedshereen