Is having insurance worth all the out-of-pocket costs we as patients get blind-sided with? There is a huge debate regarding seeing a physician that is in a provider network but the physician is not. Balance billing has started to rise as physicians want to cash in more for a patients care that the insurance will not cover. Balance billing is affecting many patients that have to pay thousands of dollars after a visit. “The Patient Protection and Affordable Care Act, informally known as ObamaCare, is a step in the right direction. United States citizens deserve affordable, accessible health care. But like all medical insurance programs, it 's a long way from perfect. ObamaCare often suffers from the same "gotcha" policies that have long gutted the protection of patients” (Spencer, 2015). “Approximately 40 percent of individuals using out-of-network physicians experience involuntary out-of-network care and cost” (Kyanko, 2013).
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Many Americans are going to in-network Urgent Care or Emergency Rooms and are being seen by out-of-network physician without their knowledge. When a patient decides to get treated by a physician thinking that it is covered, many patients find a very disappointing bill from the physician weeks later. This issue has become very controversial issue on why out-of-network physicians are seeing in-network patients and not letting them know. If a patient is made of aware of the cost associated with the visit, many would decline treatment. Doctors know what they are doing and know how to find the loop poles around the insurance coverages. Doctors feel that what they charge is fair. Doctors do not take into consideration the patients financial status and how this can affect a family. “When the doctors work in the hospital, not for the hospital, which is often the case, they’re not obliged to join the same networks as the hospital,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “And patients generally have no say in selecting those doctors” (Alberico, 2013). The right thing to do is to let the patient know from the beginning that these doctors are not in the network. This way the patients has the right to refuse or take the treatment. “A recent report by Consumers Union found that nearly 1 in 4 Californians say they were charged out-of-network rates when they thought that a provider was in-network” (Zamosky, 2013). When a patient goes in for an emergency, they do not have time to check that everything is in-network. By following the networks instructions to go to a certain facility, that should be enough to know that your services are covered. Trying to do research before you head to a facility is tough. Many of us worry about the wealth fare of our loved one and not if the doctor in the building is covered by the insurance. The idea of having insurance for all is an amazing idea, however if we do not take the stance with the government about how services are billed, then we will never move forward. Patients are finding easier to pay cash for services as doctors give a better rate and discount amount because the money is upfront. How do we expect to provide all patients with fair and equal treatment, when that treatment may lead that patient to financial ruins. “Across the country, those seemingly insignificant amounts add
Many Americans are going to in-network Urgent Care or Emergency Rooms and are being seen by out-of-network physician without their knowledge. When a patient decides to get treated by a physician thinking that it is covered, many patients find a very disappointing bill from the physician weeks later. This issue has become very controversial issue on why out-of-network physicians are seeing in-network patients and not letting them know. If a patient is made of aware of the cost associated with the visit, many would decline treatment. Doctors know what they are doing and know how to find the loop poles around the insurance coverages. Doctors feel that what they charge is fair. Doctors do not take into consideration the patients financial status and how this can affect a family. “When the doctors work in the hospital, not for the hospital, which is often the case, they’re not obliged to join the same networks as the hospital,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “And patients generally have no say in selecting those doctors” (Alberico, 2013). The right thing to do is to let the patient know from the beginning that these doctors are not in the network. This way the patients has the right to refuse or take the treatment. “A recent report by Consumers Union found that nearly 1 in 4 Californians say they were charged out-of-network rates when they thought that a provider was in-network” (Zamosky, 2013). When a patient goes in for an emergency, they do not have time to check that everything is in-network. By following the networks instructions to go to a certain facility, that should be enough to know that your services are covered. Trying to do research before you head to a facility is tough. Many of us worry about the wealth fare of our loved one and not if the doctor in the building is covered by the insurance. The idea of having insurance for all is an amazing idea, however if we do not take the stance with the government about how services are billed, then we will never move forward. Patients are finding easier to pay cash for services as doctors give a better rate and discount amount because the money is upfront. How do we expect to provide all patients with fair and equal treatment, when that treatment may lead that patient to financial ruins. “Across the country, those seemingly insignificant amounts add