Insurance companies make a killing off people like me that never go to the doctor or anything for years, but that’s still not good enough.
I spend more than $200 per paycheck, so more than $500 each month for the privilege of having health insurance. When I go to the ER, I am charged $450 for that visit on top of that monthly fee.
So the one time I actually use it because I had a bloody nose that wouldn’t stop, I get two different bills.
$450? No. That’s not enough. I have to pay $595 for that.
I know how insurance is and how they play games, so there’s nothing I can do here except pay this. I’m pissed but it’s one of those things you just get pissed about knowing there’s nothing you can do about it. They are effectively charging me for them looking at me, checking vitals, and giving me 3 nasal sprays in my nose. And I guess a prescription I never went and picked up. The visit was largely unneeded because my nose stopped bleeding in the 3 hours I waited in the “rush” lane of the ER.
But the charge that really got me? $145 for “out of network provider”. Why?
Because the facility I went to was in network. They didn’t send my blood anywhere, I didn’t go to another facility…so….how is there an out of network provider charge here?
I call them up and the lady talks like this is normal which it sounds like it is. Just a BS charge they top on top of everything.
She says that’s how facilities often do it. The physician helping me was probably a contractor that is out of network.
But the facility is in network, so what difference does this make? This sounds like a “you” issue. Tell the facility to not let this contractor touch your patients (you can’t because the law won’t allow that, but still not my problem) or to let them go and you won’t have them in network until they only have in network physicians.
This is like going to McDonald’s and the manager and bread supplier tell you that they can’t agree on a price, so you’re paying for the buns on a separate bill. Bullshit. Manager pays for it and I pay manager what quotes me. And not after all is said and done.
I might still end up paying the same fee at the end of the day, but in this moment, I am fighting the petty fight of how you are going about this because: fuck you, that’s why.
I asked the person on the phone how I can avoid this in the future. I checked and made sure this facility was in network before going (I didn’t, because that’s fucking stupid in an emergency like blood gushing out of your nose, but she doesn’t need to know that) so how can I be expected to pay for an out of network charge that wasn’t made clear to me beforehand going to a facility that is clearly labeled as “in network”?
She didn’t have an answer 🙃
She told me “we gave you a discount! It could have been $3k but we lowered it to $149 for you.”
No, I didn’t get a discount because you’re being nice because you could have. I got a “discount” because both state and federal law prevent you from charging that full amount in this situation.
I asked her “do I talk to you about contesting this or do you transfer me to another department?” Because fuck all that “can I file a complaint” BS, I phrased this exactly so you start the complaint on this because I’m not putting up with it.
She asked me why I what I was contesting. Oh okay…it’s clear we’re not getting anywhere here. Bye bye. I’ll file my complaint elsewhere but best believe that shit is getting filed and I’m fighting as long and hard as it takes.
If I go to an in network facility and nowhere else, then there is no such thing as an out of network fee. End of story. None of that makes any sense.