Helen H. Richardson/The Denver Post, via Associated Press 算是里程碑的判决吗？ She Was Told Surgery Would Cost About $1,300. Then the Bill Came: $229,000. The Colorado Supreme Court ruled that Lisa French had never agreed to pay the full price when she signed service agreements with a hospital. https://www.nytimes.com/2022/05/21/us/colorado-hospital-lisa-french.html When Lisa Melody French needed back surgery after a car accident, she went to a hospital near her home outside Denver, which reviewed her insurance information and told her she would be personally responsible for paying about $1,337. But after the surgery, the hospital claimed that it had “misread” her insurance card and that she was, in fact, an out-of-network patient, court papers said. As a result, Centura Health, which operated the hospital, billed her $229,112.13. When she didn’t pay, Centura sued her.
“I was glad not just for me, but for other people,” Lisa French said about her court victory. “I think most people don’t get, like I didn’t get, how insurance and hospitals work.”
说出了太多美国人的心声啊！美国的医疗系统真是毒瘤！ “I was glad not just for me, but for other people,” Lisa French said about her court victory. “I think most people don’t get, like I didn’t get, how insurance and hospitals work.”
说出了太多美国人的心声啊！美国的医疗系统真是毒瘤！ “I was glad not just for me, but for other people,” Lisa French said about her court victory. “I think most people don’t get, like I didn’t get, how insurance and hospitals work.” liucoan 发表于 2022-05-22 22:05
re 就是故意的，生老大网内的医院医生，麻醉师却是网外的，要价四千，那时候还是学生，月子里急得掉眼泪。生老二还是同一家医院医生，专门查了医院列出来的所有麻醉师，竟然没有一个是网内的，我的保险是覆盖非常广的大型保险公司不是小ppo，这不就是故意的么？那意思无痛生产就是奢侈品，生孩子想省钱就得受罪？还好老二生得快没怎么痛就生完了，就这样没麻醉师自付还要八千多刀，因为跨年了……
re 就是故意的，生老大网内的医院医生，麻醉师却是网外的，要价四千，那时候还是学生，月子里急得掉眼泪。生老二还是同一家医院医生，专门查了医院列出来的所有麻醉师，竟然没有一个是网内的，我的保险是覆盖非常广的大型保险公司不是小ppo，这不就是故意的么？那意思无痛生产就是奢侈品，生孩子想省钱就得受罪？还好老二生得快没怎么痛就生完了，就这样没麻醉师自付还要八千多刀，因为跨年了…… 冰糖梨 发表于 2022-05-23 12:31
所以后来法律改了，只要是在网络内医院就诊，网络外的providers也按网络内收费。 别的州不清楚，但是加州这个法律是2017年生效的, 加州的小伙伴如果收到surprise bill可以引用这个法律 1371.30, 1371.31, and 1371.9 in the Health and Safety Code, and as Sections 10112.8, 10112.81, and 10112.82 in the Insurance Code This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after July 1, 2017, to provide that if an enrollee or insured receives covered services from a contracting health facility, as defined, at which, or as a result of which, the enrollee or insured receives covered services provided by a noncontracting individual health professional, as defined, the enrollee or insured would be required to pay the noncontracting individual health professional only the same cost sharing required if the services were provided by a contracting individual health professional, which would be referred to as the “in-network cost-sharing amount.” The bill would prohibit an enrollee or insured from owing the noncontracting individual health professional at the contracting health facility more than the in-network cost-sharing amount if the noncontracting individual health professional receives reimbursement for services provided to the enrollee or insured at a contracting health facility from the health care service plan or health insurer.
所以后来法律改了，只要是在网络内医院就诊，网络外的providers也按网络内收费。 别的州不清楚，但是加州这个法律是2017年生效的, 加州的小伙伴如果收到surprise bill可以引用这个法律 1371.30, 1371.31, and 1371.9 in the Health and Safety Code, and as Sections 10112.8, 10112.81, and 10112.82 in the Insurance Code This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after July 1, 2017, to provide that if an enrollee or insured receives covered services from a contracting health facility, as defined, at which, or as a result of which, the enrollee or insured receives covered services provided by a noncontracting individual health professional, as defined, the enrollee or insured would be required to pay the noncontracting individual health professional only the same cost sharing required if the services were provided by a contracting individual health professional, which would be referred to as the “in-network cost-sharing amount.” The bill would prohibit an enrollee or insured from owing the noncontracting individual health professional at the contracting health facility more than the in-network cost-sharing amount if the noncontracting individual health professional receives reimbursement for services provided to the enrollee or insured at a contracting health facility from the health care service plan or health insurer.
算是里程碑的判决吗？
She Was Told Surgery Would Cost About $1,300. Then the Bill Came: $229,000.
The Colorado Supreme Court ruled that Lisa French had never agreed to pay the full price when she signed service agreements with a hospital. https://www.nytimes.com/2022/05/21/us/colorado-hospital-lisa-french.html
When Lisa Melody French needed back surgery after a car accident, she went to a hospital near her home outside Denver, which reviewed her insurance information and told her she would be personally responsible for paying about $1,337. But after the surgery, the hospital claimed that it had “misread” her insurance card and that she was, in fact, an out-of-network patient, court papers said. As a result, Centura Health, which operated the hospital, billed her $229,112.13. When she didn’t pay, Centura sued her.
“I was glad not just for me, but for other people,” Lisa French said about her court victory. “I think most people don’t get, like I didn’t get, how insurance and hospitals work.”
“I was glad not just for me, but for other people,” Lisa French said about her court victory. “I think most people don’t get, like I didn’t get, how insurance and hospitals work.”
什么手术，有保险，还要自付这么多啊？吓人啊。
觉得不要这笔钱损失太大，或者觉得这个大妈好欺负吧，没想到遇到个死磕到底的。
保险网外全要自付的吧
那是因为那几个人在保险公司上班，全球500强
华人大妈还说美国医疗制度比欧洲加拿大好呢
这个案子怎么就说明美国医疗是毒瘤了？ 法院的判决并没有说手术费用有问题，只是病人不用支付手术费而已，因为医院自己读错了病人保险。
医院不一定是搞错，有可能故意的，知道如果告诉病人是网外，病人就去网内医院了。
待会就有人让你滚回中国
out of network和not covered service是两大陷阱 吓人的账单很对都是这理由
这个和里程碑没有关系。 是医院自己搞错了。 如果病人搞错，估计不会这么判。 医院太无耻了，自己搞错了，还告别人。
我也觉得奇怪，医院和保险公司每个项目都有协议好的价格，为什么不可以把这个价格标注出来，然后所有病人统一收费呢？现在的情况就是你如果自掏腰包，医院收的价格比给保险公司的协议价还要低，敢情当保险公司是冤大头呢，然后保险公司也不是慈善机构，羊毛出在羊身上，找我们收巨高的premium。美国的医疗系统真的是一言难尽的说
re 就是故意的，生老大网内的医院医生，麻醉师却是网外的，要价四千，那时候还是学生，月子里急得掉眼泪。生老二还是同一家医院医生，专门查了医院列出来的所有麻醉师，竟然没有一个是网内的，我的保险是覆盖非常广的大型保险公司不是小ppo，这不就是故意的么？那意思无痛生产就是奢侈品，生孩子想省钱就得受罪？还好老二生得快没怎么痛就生完了，就这样没麻醉师自付还要八千多刀，因为跨年了……
说这话的不是拿白卡的，就是没看过病的
所以后来法律改了，只要是在网络内医院就诊，网络外的providers也按网络内收费。
别的州不清楚，但是加州这个法律是2017年生效的, 加州的小伙伴如果收到surprise bill可以引用这个法律
1371.30, 1371.31, and 1371.9 in the Health and Safety Code, and as Sections 10112.8, 10112.81, and 10112.82 in the Insurance Code
This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after July 1, 2017, to provide that if an enrollee or insured receives covered services from a contracting health facility, as defined, at which, or as a result of which, the enrollee or insured receives covered services provided by a noncontracting individual health professional, as defined, the enrollee or insured would be required to pay the noncontracting individual health professional only the same cost sharing required if the services were provided by a contracting individual health professional, which would be referred to as the “in-network cost-sharing amount.” The bill would prohibit an enrollee or insured from owing the noncontracting individual health professional at the contracting health facility more than the in-network cost-sharing amount if the noncontracting individual health professional receives reimbursement for services provided to the enrollee or insured at a contracting health facility from the health care service plan or health insurer.
这政策太恶心了，一般人那时候哪有那么多精力和时间研究这些policy，就是硬揩油。
美国的医院什么时候non profit了？
不少医院都收捐款，难道不是nonprofit？
绝大多数医院都登记为“non for profit”机构。
现在不用担心这个问题了，从2022 年开始，“No Surprise Act(NSA)" takes effective in 2022.
美国医院绝大多数登记为“non for profit” 机构。
这次做肠镜，医院、麻醉师、GI、病理医生、检验公司等等各来一张账单，张张都是一千以上，三千的也有，血常规尿常规收费一千刀，加起来各种收费上万。保险大概付了三千多吧，幸好保险还是比较给力，最后除了GI偏好、强烈指定让我去买的自费泻药付了100多外，其它没有付钱。只不过保险的premium也很咬手就是了。
这东西明码标价就是最好的啊，让老百姓放心。你说没保险的人是可以去谈upfront付钱的折扣，但你谈了也是GI，那么那些麻醉师什么的收费难道你一个一个去谈？
明明就是这么不合理的东西，这个社会却没有一个政客敢动手改变。
应该很多州都通过了，我们州也一样，我老公年初去医院动手术的时候我还问类似的问题，他说不怕，医院在network里，其它的不管，反正不能找我们多要钱。