Monday, September 22, 2014

The Legality of Unexpected Costs

Read and Learn:  http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?src=me

A growing trend in the medical field is hiring out-of-network consultations.  These consultations, usually held by the doctor and not the patient can rack up extraordinary costs.  One man was charged over $116,000 for a a doctor that he never consulted with in person but was consulted by his doctor.  Insurance companies are currently paying most of these hidden fees but question the legality of the practice.  The trouble appears to be in the negotiation of the contract and the lack of time to shop around for surgeries.  This prevents consumers from always having full information about the service they will be receiving.

Should hospitals be able to charge patients for a consultation that the patient was not aware was happening simply because a waiver was signed or is this a case of using misleading information to encourage a consumer to purchase a different service than was expected?

2 comments:

  1. Wow this gets very tricky. It looks like even insurance companies are being caught by surprise in those whole business, too. How can hospitals be discouraged from introducing out-of-network physicians that bill separately? How will this, in particular, work with health care coverage now mandated for all Americans?

    I think that a summation of fees would be very helpful for the patient, but it is probably not in the best interest of medical professionals to fully divulge the cost. The medical field is an especially tricky one because the "average" person does not know much about the human body and therefore cannot "fix themselves." This results in exorbitant medical coverage (due to a lack of information about the cost of health procedures.) Is this an instance in which we regulate? Or do we assume that our health care coverage will suffice? Is the health industry making "too much?"

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  2. I think it is making too much. Insurance should cover your agreed upon expenses. Period.

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