Patient Beware: Insurers' New Ploy

If you decide to use an out-of-network physician for services, it seems some insurers are now considering your ENTIRE bill (including hospital expenses) out-of-network (even though the physician services were performed at the same previously in-network hospital), and sticking patients with the higher deductible and payment percentage. This practice was disclosed today in the New York Times and identifies Oxford Health Plans, a division of one of the largest health insurance providers, UnitedHealth. Reportedly, other insurers have similar new arrangements.

Hospital and physician groups should lobby against this practice, since non-network, (and often specialist) physicians will be adversely effected, and these specialists will bring fewer cases to the effected hospital.

-Wes