Beware after an Accident: The Surprise Surgery Costs You Need to Know About

Something we recently heard about from clients and read about in the New York Times has gotten us angry and we want to warn you about it. It seems that more and more patients are finding significant “surprise” charges for operations and procedures.

Surprise Costs from Surgeries and Procedures Include:

• “Assistant surgeons” and other consultants and medical experts called in, sometimes unnecessarily, during procedures and operations. These doctors charge separately and are often not be covered by the patient’s insurance. For example, and anesthesiologist bringing in another anesthesiologist to help out. Often the bill for these “assistants” is larger than the main doctor, since it is billed as an out of network charge. Some accuse doctors of bringing in assistants from their practice as a scheme to bring in more revenue for their office.
• Fully trained doctors called in to assist when a staff resident or nurse would have been sufficient and come at no extra charge. For example, a recent bill for a back operation at a Long Island hospital included two plastic surgeons called in to sew up an incision at $250,000, a task that has in the past been done by a resident.
• Services that were traditionally included in the daily hospital rate but are now provided by contractors. Many hospital rooms are now often staffed with out-of-network doctors who bill separately.

There are several problems with these charges, one being that the patient knows nothing in advance. These assistants show up during a procedure when the patient is unconscious and so first finds out about it when the bill arrives. These bills can be tens to hundreds of thousands of dollars. Can you imagine going in for knee surgery at a hospital and with a doctor approved by your insurance, only to receive a bill for over $100,000 from an assistant surgeon?

Because we deal with accident victims, we know our clients are most susceptible to these charges. What can you do? If possible find out in advance any out-of-network doctors or procedures that might not be covered by your insurance. When you get your bill or insurance statement, go over all the charges carefully and don’t be afraid to protest any charges you think are unfair. It is also good to know that some added legal protection is on the way. In March, a new state law will take effect. It states that patients are not responsible for unforeseen out-of-network charges beyond what they would have paid in-network. It directs insurers and hospitals to negotiate any further payment or enter mediation.

Have questions?

Give our personal injury lawyers a call. We have experience dealing with doctors, hospitals and insurance companies and may be able to help you. Plus we can help answer any questions and provide legal options. There is never a fee or obligation for our legal advice or consultations. Just answers to your questions. Call today at 516-217-9097 or fill out our webform.