Helpful tips to avoid unexpected out-of-network charges
If you are scheduled to have surgery, it's likely that your surgeon will determine where you will be having the surgery because he/she operates at certain facilities. This also applies to any
assistant surgeon, anesthesia team, or other ancillary provider that is at the facility providing other required services; so, you may not have too much control over who is working with you.
Since you have health insurance, it's a good idea before your surgery to confirm that all physicians including anesthesiologist and any other service providers (including the facility – which may be an ambulatory surgical center) is 'in network' with your specific plan.
Many patients/members must ask for help dealing with hospital bills that they've received after their surgery. The bills are generally related to services delivered by an "out of network" provider. Since you can't confirm if someone is in or out of network while you are sleeping (under anesthesia), it’s a good idea to check or inquiry ahead of time to eliminate a headache after surgery!
Any time you are scheduled to have surgery, you should have a pre-surgery interview with a surgeon. At that time, the surgeon will review your medical history, your surgical history, and ask questions, like whether you've ever had any difficulties with anesthesia. Answer the questions honestly for your intra-operative safety. There's no point in misrepresenting your medical history.
Please use the below Pre-Surgery Checklist to maximize your benefit plan. If you have any questions, please call and speak with a representative at 800.525.8788
- Is the surgeon in network?
- Will there be an assistant surgeon?
- If yes, is the assistant surgeon in network?
- Is the anesthesiologist in network?
- Are you having Radiology services? If yes, are the results "being read" at the "seen facility" or sent to another/independent provider?
- Is a biopsy being done? Will the doctors be sending anything to pathology?
- Is the lab in network?