Is doctor’s office obligated to let you know whether or not they are in-network?

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Is doctor’s office obligated to let you know whether or not they are in-network?

When I called to schedule an appointment I was informed my current doctor had apparently moved out of state. The said they could get me in for the same services with their new doctor. I schedule that appointment. When I got my bill I found out this new doctor was not in network, therefore I owed $320. In network providers through my insurance are free. It was the same office and same services I have always received. Isn’t it their responsibility to make sure they don’t switch me to an equal product? In this case provider. Why on earth would I think they would take me out of my network. I though all doctors in that office were covered the same?

Asked on August 31, 2013 under Business Law, Washington

Answers:

M.D., Member, California and New York Bar / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

If you went to an out-of-network doctor and didn’t know they were out of network, you have a few options. You can confirm that the doctor really is out of network (which apparently yours is), you can ask the doctor to join your network or you can plead for a discounted bill (note: some health insurers offer financial relief for out-of-network doctors but it is usually a small amount).   

If none of the above work for you, then unfortunately you will be obligated to pay all deductibles, co-pays, and out of network costs for which you are billed. 

Bottom line, before going to any doctor, you should always make sure that they work with your health insurance provider. It is a good idea to even routinely check with your regular practitioner just in case they stop working with your insurer.

 


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