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