Steve had double-checked that the hospital; the surgeon, Dr. James Genuario; and Genuario's clinic were all within her Cigna health plan's network.Isabel met with Genuario's physician assistant on Wednesday, and the following day underwent a successful meniscus repair operation.
Steve Benasso said he was perplexed by the letter's meaning, adding:"We had never read or heard of anything like that before."serve as an extra set of hands for surgeons, allowing them to concentrate on the technical aspects of the surgery. Oftentimes other surgeons or physician assistants — or, in teaching hospitals, medical residents or surgical fellows — fill that role at no extra charge.
And it can be lucrative: Some of the larger surgical assistant companies are backed by private equity investment. Private equity firms often target segments of the health care system where patients have little choice in who provides their care. Indeed, under anesthesia for surgery, patients are often unaware the assistants are in the operating room. The private equity business models
self-funded employer plans. Colorado Consumer Health Initiative, which helps consumers dispute surprise bills, has seen a lot of cases involving surgical assistants, said Adam Fox, director of strategic engagement.Initially, the Benassos ignored the missive. Izzy didn't recall meeting Griffith or being told a surgical assistant would be involved in her case.
This is unfortunately not uncommon. The family asked all the right questions about insurance ahead of time & this still happened. There is clearly a lack of transparency w/medical billing. So glad the dad was an advocate for his daughter... glad she had good family support.
The medical field is full of fraud and over billing. Needs to be investigated. Ever heard of “ surprised billing”? Happens all the time.
Wow I had a full ACL reconstruction. The bill was about $14.00 CDN. For the pain meds. Somebody is doing it wrong I think.
DGlaucomflecken
Did I read that correctly? $66 for two tylenol?
Medical billing is a grift.
Most surgical assistants are not even contracted with some payers bc not seen as Physicians. They then bill the member OON and typically the surgeon has to use INN providers per their contract. She can refuse to pay and the surgeons facility would be responsible.
Almost a $ 100000 US 💵 for a knee surgery!!! Americans it doesn’t have to be that way! So what if you don’t have insurance or that kind of money ?
I remember when my dad got a statement from Medicare saying they had payed out to a doctor he had never been too. He tried to correct it but no one cared that the government was being defrauded.
I was charged $200 for the PA to poke his head into the room and tell me the doctor was on the way. American healthcare, charging patients for literally anything they think they can slip into the bill.
I can't believe I'm saying this, but this is most likely the fault of a cost accountant. What likely happened is that assistant examined some of her paperwork and the cost was allocated to the final bill with some predetermined rate.
I had to read the article twice, because this is UNBEARABLE the lengths and ease the Medical establishment will go to fleece Americans. This is highway robbery at its finest. I don't see a difference in a con artist & that private surgeon. He created debt for a 21 yr old STUDENT!
Surgeons need assistants, and it is a very small fraction of the total cost. The total number is a kicker here
American idiocy, or should I say Republican idiocy?
& this is surprising y? Ur talking about medical scamming that has been going on 4 eons!!!!!!!$$$$$$
Well she got an early lesson that we have a healthcare market not a healthcare system.
Great reporting.....
spidadoc1 interesting
This happens all the time - it’s enraging
Pretty good system we got here...
Health care is in crisis in US. & Insurance Companies are the problem. This bill is abusive!!
I have seen charges from docs who walked by the surgery room. In network, out of network. The insurance companies are taking huge profits which President Obama tried to stop and trump has rescinded via EOs. Some of the Covid treatment bills? Bankrupting!
We're constantly advised to ask questions about billing, what's covered and what's not prior to service, but here's the thing, no one knows how much it costs until submitted to insurance. Medical providers are rarely able to quote me costs, even for self pay.
The American Academy of Orthopaedic Surgeons AAOS1 advocates for the use of surgical assistants. Don’t believe ortho surgeons that blame the hospital, it’s the surgeons that choose, and most routinely use an assistant. Here’s their position paper on this.
Always get an itemized bill , check charges and get an audit if you see something fishy!
This total scenario shows what a scam our health system and insurance system is. With no insurance at all this person would have been asked to pay the complete $96,000 bill and look what they settled for with insurance. Absurb
Or in my case they just keep coming up with new bills for the same procedure almost a year later.
If you're having elective surgery, 'Chhabra said patients should ask their surgeons before surgery whether an 'assistant' will be involved and whether that assistant is in-network.' Otherwise, you may be stuck with a bill for $1,000.00's
I’ve had this happen too.
Our health care system is totally out of control. 😳
She already got a ski pass We don't even have organized plans for how they are going to open the ski resorts yet. lol Maybe this is just karma from the handful of nutters that demanded the park tennis courts be open during the covid lockdown.
Oh, yeah. Had a similar experience at a hospital for an outpatient procedure. Pretty much any doctor or professional who walked in my room that day sent me a bill. He/she could claim that 'I was seen' by that person.
I had a similar problem not long ago and sent a letter to the Fla. Depart. of Agriculture, which was forced to investigate and the balance bill was retracted. Good thing she has insurance. She should consider the spelling of her name when she writes in.
SallyCat100 The US complains that universal health care in other countries leads to 'death panels' (they don't exist). Meanwhile hospitals bankrupt people and insurance companies look at anyway to decline a claim to maximise profit.
I don’t want socialized medicine because I want to keep my *checks bill* ghost doctors who never saw me.
Don’t pay it...
This is why we need MedicareForAll
And in America she received the best care modern medicine can offer. If this had been done in Canada, the UK or god forbid a developing nation, she would likely experience complications, surgical failure, and eventual death.
This isn't normal. This shouldn't be presented as though it is normal.
Universal healthcare!! Our system is broken.
In any other decent country this would be free, or at most a few dollars worth of out of pocket costs. Only in the US can you have a system that is this convoluted and expensive.
'The private equity business models include keeping such helpers out-of-network so they can bill patients for larger amounts than they could negotiate from insurance companies.' Translation: this is a scam. Look for collusion between the surgeons and surgical assistants.
MedicareForAll
Umm...the “kicker” is the 96k. I’d be more worried about that than the $1,100 charge for the phantom physician.
USA health care is a broken system. representus
What a joke.
My favorite has been receiving a bill for a surgery I paid for in-full. The bills incl’d different charges; the received bill was mysteriously cheaper; and no one could tell me why I’d received a bill at all, since the previous payment info was available.
Free in Australia.
God love her. This is so wrong on so many levels, but at least she got her knee fixed to fight and kick the bill into touch.
Dystopian science fiction
This'll be the UK soon
Or in New Zealand the bill would be $0 - or minimal costs.
The solution: MedicareForAll