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America’s health care still face a big problem of unexpected medical bills. The issue puts many Americans at high death risk. Experts say in the healthcare, mainly hospitalization, there are full of unexpected and unwelcome cost burden on the patients even though they have a planned procedure.
An unexpected medical bill of whopping USD 117,000 came as an extremely unpleasant surprise for a New York City bank technology manager who has undergone a neck surgery to get his herniated disks repaired in December last year.
Being a banker, Peter Drier, had done a good homework on his insurance coverage and medical expenses prior to the surgery but a fat bill from an assistant surgeon was a big shock for him.
Drier was well-prepared for the medical bills from the surgeon, the anesthesiologist and the hospital as they all were covered under his insurance plan. Besides, all three would accept their negotiated charges. But the additional fees charged by the assistant surgeon were out of network of the insurance coverage.
Drier’s medical insurance firm, Anthem Blue Cross Blue Shield, had agreed to protect him for the unexpected out-of-network bill saying that it was not his fault and he is not liable to pay the assistant surgeon cost as they will cut a cheque for the total amount of the bill for him.
When Drier received the cheque from his insurer he didn’t forward it to the assistant surgeon immediately hoping for better negotiation to save his insurance firm’s money. However, he had to reluctantly send the Blue Cross cheque after he received a threatening letter from the lawyer of the assistant surgeon.
It is virtually impossible to avoid such unexpected medical bills, specifically when the hospital stays and surgeries are required for the patients. Medical experts say in such a scenario, even the most health insurance literate patient faces trouble in tracking down the information they require.
While receiving the services at the hospital, the patients are at the end left with billing that has common wording on financial consents:
“I understand that the physician services I receive (including attending and consulting physicians, surgeons, anesthesiologists, pathologists and radiologists) are usually hired separately and that any attending and consulting providers may bill me separately.”
The financial consent also includes the common acceptance statement:
“I agree to pay for all services rendered to me without regard to benefit limitations that may be imposed by any insurance carrier, unless prohibited by law or contract.”
Signing such consent forms becomes usually mandatory for the patients or their families as they are left with no other option to get the medical care services that are not necessarily know to them. What costs do these services will levy or whether they are covered under the patient’s insurance plan.
Experts say the complete US medical system and the financial aspect associated with it is extremely complicated. To comprehend them properly is even nearly impossible for the most knowledgeable and insurance savvy patient.
The New York State Department of Financial Services has said that the issue of unexpected medical bills has not been directly addressed in the United States and continues to burn the pockets of the common man.