Orthopedics Hip, Knee, and Shoulder Injuries Forum - My Podiatrist Scheduled my Surgery at OutofNetwork Hospital
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My Podiatrist Scheduled my Surgery at OutofNetwork Hospital

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Medical Questions-> Health Forums -> Orthopedics Hip, Knee, and Shoulder Injuries -> My Podiatrist Scheduled my Surgery at OutofNetwork Hospital
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2egua

New User, Becoming EHEALTHy
Joined: 06 Jun 2008
Posts: 1
My Podiatrist Scheduled my Surgery at OutofNetwork Hospital
Posted: 06-06-08 12:55pm

I'm trying to get some advice on who is responsible and whether I have any legal recourse.

I have Anthem Blue Cross Insurance and went through Podiatrist who was in the Anthem Provider Directory. I was very comfortable with the surgeon and decided to go ahead with the surgery he recommended. Things went great, I'm healing well, but got a hell of a shock when I received a bill from the Hospital. I called Anthem and they told me the hospital was out of network which is why I was receiving the Bill. I'm confused becuase if I was in-network with the surgeon why would they schedule the surgery at the Hospital that is not with Anthem?

At no time did the office consult with me about the Hospitals they should schedule my surgery at, and didn't inform that they could possibly use facilities that were out of the Anthem network. The Dr's office is in turn blaming the Hospital becuase they said at my pre-registration (which was the day of the surgery) they should have notified me that I was not covered by my Anthem Insurance.

All I know is I'm the one holding the Bill. I have appealed to Anthem but fear that they ultimatley will put the responsibility on me for not double checking that I had been scheduled in an in-netwrok hospital. Most friends I have talked to think what happened is BS, and say that they too would not have thought to have checked the Hospital if the Dr's office were handling the scheduling of this and that they were in-network with the Surgeon.
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CarolDiane

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Joined: 23 Sep 2007
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Hi Jonathan
Posted: 06-11-08 06:58am

Welcome! Great you found us. I am going to move your topic to the proper forum so it will get some good replies for you. If there is anything you need, just ask. We are very user friendly. Wink

I am moving thies thread to "Orothpedics" forum for you. Then you will be on the right forum for the right replies.
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