Brain Handles

Last year, I created Doctor Tricks to tell the tale of how I got bit for extra money at a hospital. Thing was, though the hospital was a preferred provider on my medical insurance, none of the emergency room doctors were. I ended up getting bit for an extra $153.50 for the ER doctor's bill because he charged more than my medical insurance allowed.

But while doing research, I found another thing. First the state Insurance Commissioner's office mentioned it, then friends and visitors to the site told me stories of it. Anesthesiologists were big perpetrators of this game. If you had to have emergency surgery, you'd be lucky to pick your surgeon, much less your anesthesiologist. Knowing this, anesthesiologists were taking advantage of people's distress and lack of choice to pick their pockets.

Most of the stories I heard about this weren't about trauma surgeries, though. They were births. The general story went: the parents-to-be went into a preferred provider hospital to give birth, had to have a caesarean section, the anesthesiologist for the c-section wasn't a preferred provider on their insurance, and they ended up having 500-1000 tacked onto their share of the bill after the insurance payment.

Now, it's common to pick the hospital you give birth at based on where your obstetrician has privileges. You've been seeing this doctor for months. You trust this doctor. You want this doctor to deliver your baby.

You make sure the doctor is a preferred provider on your insurance and that the hospital where they have privileges is a preferred provider, but you don't think to ask about the anesthesiologists. You should.

You should also write your congressman and senator and ask them to introduce Federal legislation, an amendment to the Patient's Bill of Rights, making it illegal for an insurance company to certify a hospital as a preferred provider unless all the doctors and service professionals are preferred providers.

It's ridiculous that you need to not only confirm that a hospital is a preferred provider on your insurance, but that all their subcontracting medical corporations (ER docs, radiologists, anesthesiologists, etc.) are preferred providers. And it's difficult to do to, because the medical corporation doesn't have to have the same name as the hospital, so you're forced to check the addresses of local radiology services and emergency medicine services against the address of the hospital.

Until there is federal legislation that makes it possible for consumers to quickly and easily determine whether all the services they receive at a hospital are insured, dishonest docs are going to take advantage of this to pick your pocket at the most emotionally, physically, and financially vulnerable times of your life.

So if you're pregnant and trying to pick the best obstetrician, make them do the work. Make them find out if the people who will take care of you at the OB/GYN's preferred hospital are preferred providers. If they can't answer or won't answer, maybe they're not as deserving of your trust as you thought. And if they answer no, when you tell them you'll have to go to another doctor, maybe it will give them incentive to join the fight against this underhanded practice.