Two days in the hospital is how much!!? I thought I had insurance!

Today I have been battling the great faceless Corporate Insurance Giant.

Here is the story. My Client, let’s call him Billy Bob, starts developing pain, real pain, the bend you over until a grown man cries pain. Now, a regular guy would have taken several hundred Advil chased with a beer. Not this guy, he’s intelligent, and decides to go to the Hospital Emergency Room. However, despite the searing pain, Billy Bob has the foresight to actually make sure the Hospital he goes to is in his Health Insurance Plan’s Network. Luckily, the insurance company website lists the Hospital as being In-Network! He goes to emergency, gets admitted immediately, and after two days of quality medical care, is discharged.

Billy Bob isn’t worried though, because the Hospital was in his network and therefore most bills should be covered or discounted, right? Then the bills start showing up, big bills, multiple bills, bills the size of small SUVs. Billy Bob is stunned, how could it have been so much? Remember when I said Billy Bob was pretty smart? Looking the bills over he discovers something no one usually would; the Hospital was indeed in his network, but many of the doctors (who belong to their own separate doctor networks) working at the Hospital were not! Thus he gets billed super high rates for out of network doctors at an in network hospital! Not just a few out of network doctors mind you, he was in for two whole days and thus he gets billed from multitudes of specialists all billing from their separate networks!

This is why there is so much anger focused on insurance companies. It’s not the level of care he received, it was excellent and he made a full recovery, but rather the coordination of benefits and billing issues that are dumbfounding.

Needless to say we are arguing that all his services should be covered at the less expensive in network coverage level. How will this turn out? My guess is the great Corporate Insurance Giant will throw us a bone on some charges. That would be nice, but it doesn’t solve the problem.