Monday, December 16, 2019

Still Waiting For A Real Solution




You are in the hospital preparing yourself, mentally, for surgery when a doctor enters pre-op.  He introduces himself as Doctor Jones, the anesthesiologist.  He has been asked to participate in today’s procedure.  He is NOT in your network.  This is no time to spring a surprise on you.  You are prepped and ready.  Dr. Jones is prepared.  He has a form for you to sign and he reads the first paragraph that includes these key points:
  1. The individual provider informs the covered person that the individual provider is not in the person's health benefit plan provider network.
  2. The individual provider provides the covered person a good faith estimate of the cost of the health care services. This estimate shall contain a disclaimer that the covered person is not required to obtain the services at that location or from that individual provider.
  3. The covered person affirmatively consents to receive the health care services.
Here’s the question – Do you sign his form or do you put on your clothes and go home?    
                                                                                         
Those three points are directly taken from the current Surprise Billing legislation Ohio S B 198.  Until this loophole is removed, Ohioans will still be victimized by Surprise Billing.

DAVE

www.cunixinsurance.com

Picture – You Had A Choice – David L Cunix

2 comments:

  1. Posted by super-reader Sandy on the website:
    Sandy says:
    December 17, 2019 at 12:13 am (Edit)
    That fuzz tone. They get you with the fuzz tone, man.

    ReplyDelete
  2. A comment and my response that were posted on the website:
    im Scaparotti says:
    January 24, 2020 at 5:59 pm (Edit)
    Dave, so let’s say that actually happens… what would you do?
    Reply
    dave@cunixinsurance.com says:
    January 24, 2020 at 7:51 pm (Edit)
    Jim:
    I don’t know. I would hope that I had the strength to get up and leave. I spent hours trying to verify that all of the doctors that were going to treat me back in April 2016 were in my network. I COULDN’T. Luckily they all were. I was not victimized by surprise billing. But to be clear, I was fortunate.
    DAVE

    ReplyDelete