My Name: Alan
Claim Amount (Approx.):
My Complaint Description:
I received services at the Banner Baywood Emergency Room on two separate occasions in October and November of 2013. I have Humana insurance and this hospital is in my network of preferred care. On one visit my Humana insurance paid all the bills sent to them from Baywood Emergency. On the other visit here was an additional bill from another company (not Banner Emergency). This bill was not completely paid by Humana because they were out of network and submitted the bill as outpatient services not emergency room services. This company wanted me to pay the additional charges that Humana did not pay.
Humana asked me to tell them to submit another bill as an emergency room billing not outpatient billing and that they would make an adjustment. But instead they sent it to collections and now I am being harassed by them to pay the additional charges. Apparently Banner Baywood Emergency allows out of network doctors to provide services at this facility but no one tells you that they are not in your network of providers.
These out of network doctors do not properly bill your insurance and expect you to pay for the additional charges that the insurance does not cover. I am sure that I signed something when I was admitted that says somewhere in small print that this is what they are allowing but this is clearly a deceptive practice in that you are in a situation where you are under physical and mental duress and prompted “Just sign here.” I thought that did everything that I was supposed to do by going to a facility that was in my Humana network but Banner Baywood did not properly inform me of the fact that they were allowing out of network doctors to provide services.
I never would have allowed this out of network doctor to provide any services if I had known the facts. So on one visit I got lucky and had all in network doctors and the following week on my next visit I had an out of network doctor and now am expected to pay hundreds of dollars more for services.