How to Reduce Medical Bills Even if the Doctor is Out of Network

So I’m going to tell you a really crazy story. I handled a case where this woman had a blockage in her fallopian tubes. She was having a rough time getting pregnant. So she had an HMO policy and the doctor she hired was not on her plan.

The doctor who is performing the surgery did not take it. He didn’t take any insurance at all and but very often he could get paid if it wasn’t an HMO, so what he did is he brought another doctor into the surgery room to first perform the incision. And you know, it’s almost like acting like he was having problems. So he brings in this other doctor who’s not part of the HMO.

After the first incision, then the non-participating doctor took over from the non-participating doctor from the insurance company because he didn’t have them who wasn’t on the HMO. He charged a patient $32,000. We were going back and forth believe it or not, with the State Attorney General’s office. But they would not force the insurance company to pay since the second surgeon was not on the HMO plan.

So what wound up happening at the end, which is very interesting to me, the the Doctor who is not on the HMO went back to the first doctor we brought it to the case and took money from the first Doctor Who, when only to the point of starting the  incision.  So if you ever need help with your medical bills, please keep me in mind Adria Gross Medwise Insurance  Advocacy.

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Adria Gross
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