| Unfortunately, paying for health care these days - | | | | insurance policy, whether it is group, government |
| whether it's hospital care, group or private health | | | | provided, or private health insurance. Call your |
| insurance, or durable medical supplies - is a lot like | | | | doctor and ask what kinds of surgery-related |
| buying a car: You gotta haggle. If you can | | | | expenses a patient is generally expected to |
| research and take care of your out-of-pocket | | | | cover. These may include radiology (x-rays), |
| expenses prior to surgery, it's possible and wise | | | | consultation with out-of-network specialists |
| to negotiate with the hospital and providers for a | | | | (whose fees are also negotiable), pathology, and |
| lower out-of-pocket rate. | | | | even blood transfusions. Then, starting with the |
| For example, say you know you have elective | | | | finance department, call the hospital and ask them |
| surgery coming up, and you've discussed it with | | | | which service providers operate outside of your |
| your doctor and agreed on a date. His office | | | | network, and get ready for the talks to begin. |
| already has the paperwork process underway | | | | Explain what your insurance provider will cover |
| with the insurance company, and you read | | | | and what you can afford to pay for the rest. |
| through your policy and find that it does not | | | | Many hospitals today have made their pricing |
| cover out-of-network anesthesia. What do you | | | | policies transparent and therefore have prices |
| do? You might call the hospital and ask how many | | | | posted to the hospital Web site or readily available |
| in-network anesthesiologists they generally have | | | | for consumer perusal. Keep in mind that the |
| on hand at the time when you've scheduled your | | | | hospitals offering such practices also only |
| surgery. If you know there's a good chance the | | | | guarantee the prices from the date of printing (or |
| person who is going to provide that service is not | | | | publishing); all the same, armed with this |
| going to be covered by your policy, this is where | | | | information you can at least get a rough idea of |
| the negotiations start. | | | | the price range you're dealing with. |
| Today, we have to negotiate these kinds of | | | | According to one lawyer at the Texas State |
| things, as difficult as that seems in light of any | | | | Department of Insurance, pricing is not the only |
| health issue. We also have a growing rate of | | | | thing you can tweak. "You can also talk to your |
| tiered billing practices, so we can be charged | | | | own doctor and see whether he can find other |
| anything from what a provider like Medicaid or | | | | providers at the hospital who wouldn't be |
| Medicare might have to pay, to the price level of | | | | out-of-network. If you have one surgery date, |
| an uninsured patient, which might be substantially | | | | but that scheduled time doesn't coincide with the |
| higher, but since the charges aren't necessarily | | | | physical presence of in-network providers, but |
| standardized, there's a lot of room for discussion. | | | | another time does, well, you'd choose a different |
| Many hospitals charge uninsured individuals a lot | | | | time, wouldn't you?" He also said to be on the |
| more for services so they can make up for | | | | lookout for words like "allowable," "usual," and |
| costs lost elsewhere in their operations. The point | | | | "customary" in your policy, because those usually |
| is, from one end of that spectrum to the other, | | | | signal "points of flexibility," and we could all use a |
| there's a lot of negotiation room. Knowledge is | | | | little flexibility with insurance companies and |
| power, especially in this scenario. | | | | hospitals. |
| Start with reading and digesting your health | | | | |