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"Calver asked whether his health insurance would cover all of this... The hospital told him not to worry and that they would accept his insurance." From my exp

"Calver asked whether his health insurance would cover all of this... The hospital told him not to worry and that they would accept his insurance." From my experience, it is completely legal for any medical practitioner to say they accept an insurance even though they really do not.

maxxxxx 8y ago
That's just nuts. As patient you go in blind and can just hope for the best.
lacker 8y ago
From my experience, no human at the hospital has any idea whether they will accept your insurance or not. The doctors certainly don't. They just report things into the bill-processing system which occasionally delivers patients a crazy $100,000 bill.
- dboreham 8y ago
  They have no idea if the insurance company will pay. I know this from personal experience where the hospital explicitly called insurance co to ask if a procedure would be covered, received confirmation that it would be, AND the hospital recorded the call. But coverage was subsequently denied.
- benbreen 8y ago
  Yep, this happened to my wife - she needed a fairly intensive and costly surgery and was told she was in-network and covered. It turned out the person on the phone was wrong and she ended up having to cash out her entire 401k to pay the 20k+ bill. We learned a lesson about the US healthcare system with that one...
exolymph 8y ago
Mere acceptance of insurance doesn't mean there won't be an exorbitant copay, anyway.
dboreham 8y ago
"accept an insurance" doesn't mean what you think it means. It just means they will exchange paperwork with said insurance company. Whether or not your policy/company covers treatment is a completely different issue.
mgkimsal 8y ago
"we accept it" is nowhere near the same thing as "the insurance company will pay for it". Of course they'll "accept" it, it just may not make a difference as to what you owe. they'll put it in their system. the words used here have vastly different meanings to each party.
s73v3r_ 8y ago
Yeah, but if they say that, then they should be responsible if they are wrong.

maxxxxx 8y ago

That's just nuts. As patient you go in blind and can just hope for the best.

lacker 8y ago

From my experience, no human at the hospital has any idea whether they will accept your insurance or not. The doctors certainly don't. They just report things into the bill-processing system which occasionally delivers patients a crazy $100,000 bill.

dboreham 8y ago
They have no idea if the insurance company will pay. I know this from personal experience where the hospital explicitly called insurance co to ask if a procedure would be covered, received confirmation that it would be, AND the hospital recorded the call. But coverage was subsequently denied.
benbreen 8y ago
Yep, this happened to my wife - she needed a fairly intensive and costly surgery and was told she was in-network and covered. It turned out the person on the phone was wrong and she ended up having to cash out her entire 401k to pay the 20k+ bill. We learned a lesson about the US healthcare system with that one...

exolymph 8y ago

Mere acceptance of insurance doesn't mean there won't be an exorbitant copay, anyway.

dboreham 8y ago

"accept an insurance" doesn't mean what you think it means. It just means they will exchange paperwork with said insurance company. Whether or not your policy/company covers treatment is a completely different issue.

mgkimsal 8y ago

"we accept it" is nowhere near the same thing as "the insurance company will pay for it". Of course they'll "accept" it, it just may not make a difference as to what you owe. they'll put it in their system. the words used here have vastly different meanings to each party.

s73v3r_ 8y ago

Yeah, but if they say that, then they should be responsible if they are wrong.