Out-of-Network Surgeons Increasingly Perform Wallet-ectomies

A practice known as drive-by-doctoring is leading to big, unexpected bills for some unwitting patients.

Out-of-Network Surgeons Increasingly Perform Wallet-ectomies Photo (cc) by slightly everything

Imagine going in for surgery and expecting to receive medical bills totaling no more than $200,000, only to be blindsided by an extra $117,000 bill for an assistant surgeon you didn’t even know was going to be working on you.

According to The New York Times, that was the unfortunate reality for 37-year-old Peter Drier, who underwent a neck surgery for herniated disks in December. Drier said he had researched his health insurance coverage, as well as the surgery fees – $4,300 for an anesthesiologist, a $56,000 hospital bill and $133,000 for an orthopedist (who accepted a negotiated fee from Drier’s insurance company of $6,200, the Times said).

So Drier was understandably shocked when he received a $117,000 bill from a neurosurgeon he hadn’t heard of before. The Times said:

In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.

As insurance companies reduce their reimbursement rate for services, drive-by doctoring can boost revenue for physicians and other medical workers. An out-of-network doctor can charge a much higher fee than those negotiated by in-network providers. Some insurers are challenging the huge costs in court.

If you’re going in for surgery at any time in the near future, beware of surprise fees. According to the Times:

In some instances, a patient may be lying on a gurney in the emergency room or in a hospital bed, unaware that all of the people in white coats or scrubs who turn up at the bedside will charge for their services. At times, a fully trained physician is called in when a resident or a nurse, who would not charge, would have sufficed. Services that were once included in the daily hospital rate are now often provided by contractors, and even many emergency rooms are staffed by out-of-network physicians who bill separately.

Drier’s insurance company ponied up the money and sent him a check to pay the $117,000 out-of-network physician who assisted in his surgery. Though Drier told the Times he didn’t want to pay the bill because he believed it to be “outrageous and immoral,” he did end up signing over the insurance payment to the surgeon after he received a letter from the surgeon’s lawyer.

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