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:
- The individual provider informs the covered person that the individual provider is not in the person’s health benefit plan provider network.
- 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.
- 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.
Picture – You Had A Choice – David L Cunix
That fuzz tone. They get you with the fuzz tone, man.
Dave, so let’s say that actually happens… what would you do?
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.