[quote=FlyerInHi]BG, you may see the bills AFTER. What’s the point after when you have no choice but to pay, or the bill has been paid already? Patients don’t think of costs, and don’t get to consider costs/benefits before using services. That’s perverse.
The difference between you and me is that I have no problem separating my own personal situation from policy.[/quote]
It’s not about me, FIH. That’s the way indemnity plans and PPO plans are. I just happened to have those kinds of plans (as well as Tricare Std) all of my adult life so have experience with them.
As a member of one of these plans, you already KNOW what your deductible and co-insurance ceiling is and what the percentage will be of each bill that you’re responsible for.
If you know if advance you are going in for a procedure, you can ask the provider directly in advance if their anesthesiologist is part of your plan’s network so you won’t have any surprises on your bill. You can also ask them for an estimated total cost of the procedure and how much of it you will be responsible for. Better yet, you can go online to your (PPO) plan’s website in advance of your scheduled procedure and look up ALL the providers (dr, facility, anesthesiologist, etc) to see if they are in-network as well as see what they perceive is a “typical cost” for that procedure in your region.
Obviously, if you get carted off in an ambulance to an emergency room, you won’t know in advance what kind of treatment you will need when you get to the hospital. A PPO planholder will have to go with the flow and let their carrier hash the bill out with the hospital. They already know what their emergency room copay will be if they aren’t admitted and all of their deductibles and coinsurance as mentioned above.
