I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
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Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#2> [surprise bills]… often stem from patients unwittingly receiving care from out-of-network providers…
If you do not have the agency to select an in-network provider (because you are mortally wounded / incapacitated / etc.), then the out-of-network provider should be legally transmuted into an in-network one. The insurer should be compelled to pay, and the provider compelled to accept it.
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#3> [surprise bills]… often stem from patients unwittingly receiving care from out-of-network providers… If you do not have the agency to select an in-network provider (because you are mortally wounded / incapacitated / etc.), then the out-of-network provider should be legally transmuted into an in-network one. The insurer should be compelled to pay, and the provider compelled to accept it.
I believe that's the way it works. And then you have to transfer to in network provider as soon as humanly possible (perhaps not as humanely possible...)
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#4Aren't you assuming that the healthcare system operates for the good of the patients? From my point of view, that doesn't seem to be the case in the U.S.
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#5The healthcare industry in the US sometimes gets me to seriously consider seeing a shaman next time I get sick
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#6I have MS and receive an Ocrevus infusion every six months. It's a labyrinth of a process. UHC (insurer) sub-contracts(?) to CVS Caremark to provide specialty drugs. CVS insists on calling me to confirm they can ship it to my house. F no! I'm not running an IV for myself. Sort it out with the hospital.
Last go around, the hospital coded the drug as coming from their supply instead of CVS so I got a surprise bill for $130,000+
Luckily, I've been through the process so there's records of the normal billing path. I fought the Hospital billing department and 5 months later I'm billed $700 which was about the expected amount.
It was still stressful and time consuming to figure out if I screwed up to the tune of 6 figures.
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#7$10000 looks like he got off easy given he visited an ER. Some unfortunate ones have to pay close to that amount just for the privilege of sitting in an ER, without getting any meaningful treatment.
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#8There are some good points in here. However, it feels disingenuous with the author being a former surgeon general.
"the onus of the entire amount still fell on me due to my high-deductible health plan (HDHP)."
I mean, yeah, that's how HDHP works. Anyone in healthcare should understand that.
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#9What I find interesting is how in OP's original tweet, more than half of the comments blame him for the cost. Shouldn't have gone to that hospital! (it was the closest one). Should've drunken more water! etc. pp.
Like the proverbial crabs in a bucket, only pulling each other down. https://x.com/JeromeAdamsMD/status/1761375417351430595
Re: I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill
#10> [surprise bills]… often stem from patients unwittingly receiving care from out-of-network providers… If you do not have the agency to select an in-network provider (because you are mortally wounded / incapacitated / etc.), then the out-of-network provider should be legally transmuted into an in-network one. The insurer should be compelled to pay, and the provider compelled to accept it.
I believe that's the way it works. And then you have to transfer to in network provider as soon as humanly possible (perhaps not as humanely possible...)
One of the problems here is that the patient can believe they're at an in-network provider — and be correct about that — and still get hit with "out of network" charges.
One of the linked articles[1] explains it slightly better:
> Surprise medical bills happen when a doctor or other provider who isn’t in a patient’s insurance network is unexpectedly involved in a patient’s care. Patients may go to a hospital that accepts their insurance, for example, but get treatment from emergency room physicians or anesthesiologists who don’t — and who then send patients big bills directly.
I've seen this in my own medical billing: often times, I will get bills (to the insurance) from "providers" I had no (direct) interaction with. And that's the thing: if a in-network provider contracts/vendors/(who knows, I don't know how their business is structured) to some other company, you get billed "randomly". Sometimes I can piece together exactly what action caused it (e.g., okay, that ultrasound is this random charge), but not all the time.
Insurers refuse to help: they claim it's not their problem, as they're not billing you. Providers will claim they know nothing; after all, it isn't them that billed you.
[1]: https://www.nytimes.com/2021/07/01/upshot/surprise-medical-b...