I went to Emergency room (INOVA) with a broken which referred me to Dr Christopher Hess as he is the on-call doctor. His office didn't explain me that he is not in the network of my insurance company. Dr Hess suggested to have a surgery done on my finger but failed to mention that this costly surgery could have been avoided with a regular splint.( I came to know about this option later after I got a second opinion, but unfortunately I got it after the surgery) .
My insurance paid him $2500 as an out of network doctor which is 80% of their allowable amount but he charged me around $4000(6500-2500).
Apparently you don't know what your doctor?s bill is until its late. The law doesn't require a doctor to disclose the bill, perhaps due to heavy lobbying of American Medical Association.
No wonder more than half of bankruptcies are medical bankruptcies, even more surprising is 75% of them have medical insurance( as per a Harvard University study)
I feel Law need to make doctors and hospitals disclose their rate/bill or make a standard rate/bill for each type of treatment which is agreed by insurance and doctors. In my case, Insurance thinks that the treatment is worth around $ 3000 but doctors says it's around $6500. This is a huge gap(more than 100%).
Pros: specialist
Cons: money minded ,didn't explain options
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