How to negotiate medical bill from doctor outside my insurance network? I felt like being cheated into this.?

Question

My wife had an emergency last week and was admitted to a hospital nearby, doctor A (both the hospital and the doctor are in my insurance provider network, which is PPO) ran a couple tests on her and could not figure out what was wrong. Doctor A then said he would ask another doctor to come in the next day to check on her. At that point, I was not at the best moment of judgment and trusted the doctor would make the best decision for us, so I did not object.

The next day morning, doctor B came in, looked through the test results, talked to us for about 15-20 minutes, then he said we should go home and came back in 3-6 months to have another test. It gave us some relief and we left the hospital.

Couple days later I got the bill for doctor B, $2000!!! What's worse, he is not in my insurance provider network, and I haven't met the deductible limit, so all two grand will come out of my pocket!! Not to mention we are expecting the hefty bills for all those tests the hospital ran on my wife...

We are very upset, whether or not doctor B's half an hour visit is worth $2K is one thing, but doctor A knew what kind of insurance we have, he still brought in someone outside my network without telling us beforehand, especially at a time we were in shock and did not know what to do.

I'm going to try to negotiate the bill with doctor B, any suggestion how I should approach this? Also, if the negotiation does not work, is there anything I could do to protest this? Thanks!!

Answer 1

you need to get on the phone with your insurance and plead your case.  as a patient in the hospital your wife had no way of knowing that dr b was not in her insurance plan and did not have a choice of being seen or not.  you might have to write a letter of appeal to your insurance company.  they should cover the visit as if he was under your insurance.  also talk with the dr directly and see what can be done on his part, maybe he can reduce the fee.  don't let them win, keep fighting.  i was threatened more times than i can count to be sent to collections regarding a surgery my son had.  it took me about a year but his $9000 anesthesia bill cost me $12.  

ps.  every time you speak with the dr, office, or insurance keep very detailed notes as to who you spoke to, date, time, etc.  i had to call them almost every day.

good luck