Surprise! Your anesthesiologist is out-of-network
By Consumers Union on Thursday, August 28th, 2014
Lisa N. from Santa Cruz, California, wrote to us sharing her medical bill-shock story from a recent pregnancy. When the time came, Lisa checked in to her local in-network hospital and used her in-network gynecologist and the approved in-network neonatologist. She hadn’t been planning on getting an epidural, but ended up needing one. “Did I need pain relief? Yes, most definitely yes,” says Lisa. “I left the hospital with a healthy baby, 10 hours after entering it, totally unsuspecting of what was to come in the mail.”
Lisa told us she eventually found out that the anesthesiologist worked at the hospital, but was considered out-of-network. She got a copy of the full bill, even though she had insurance. The hospital stay worked out to be about $1,000 for the room and nursing services, $1,000 for the doctor and the delivery, and $3,000 for the out-of-network anesthesiologist. Everything was covered under her insurance, except the most expensive thing: the anesthesiologist.
Even worse, Lisa says, “I eventually found out that there were zero in-network anesthesiologists at that hospital.”
“In this situation, when you really need pain relief, and the anesthesiologist is called in, I don’t know anyone who would be capable of asking “Are you ‘in-network’?” Lisa continued. “The anesthesiologist is the most expensive part of labor and delivery – and in the situations where you need anesthesia, you aren’t going to ask if they’re in-network. They totally have you over a barrel.”
Lisa’s not the only one – many consumers have written to us about being surprised by an out-of-network bill, or being given wrong information about which doctors are in a plan’s network. We know from stories like these that provider directories can contain errors and wrong information – and that even doctors sometimes don’t know what networks they’re in.
If something similar has happened to you, we want to know about it so we can help make health insurance easier to use for everyone. Share your story here.