facebook Doctors working in the ER aren’t necessarily in-network

BIG PHARMA POLITICS: Consumers pressure politicians to do something about rising drug prices. Read More

Doctors working in the ER aren’t necessarily in-network

Not many people might have had Scott Kohan’s presence of mind to check whether the ER he woke up in was in-network.

With a broken jaw and staples in his head, he checked his phone and found that the hospital was listed as in his network.

Still, he ended up with a $7,924 bill.

Surprise, the oral surgeon in the hospital’s ER wasn’t in network.

Kohan’s story is another in Vox’s ongoing series about surprise medical bills. And the ER is a frequent source of those surprises. Doctors who work in the ER aren’t always part of the network, even when a hospital is. When you’re in an emergency, you don’t always think to check – and sometimes, if you’re unconscious, you obviously can’t.

The hospital was in his network but the oral surgeon wasn’t.

Vox talked to Christopher Garmon, an assistant professor at the University of Missouri Kansas City, who published a study showing 1 in 5 ER visits resulted in a surprise bill from an out-of-network provider.

Kohan’s bill was eventually forgiven by the doctor, who participates in no insurance networks. The hospital wouldn’t tell Vox why it contracts with doctors who don’t take insurance. How would a patient know? Or what choice would they have?