Question:
Just curious...when making sure that one's hospital and surgeon are in network, does

one also have to make sure that the anethesiologist and others assisting in surgery also have to be in network? I'm wondering if after surgery, I will get a bill from an anethesiologist or another doctor who claims not to be in network with Aetna.    — Susan F. (posted on April 22, 2003)

April 22, 2003
I would definitely check to find out if ALL that are involved are in network. My insurance company provides an online provider directory where you can check it yourself. Many surgeons will only use a certain anethesiologist and assistant, so you may still have to pay the out of network cost for those services, OR look for another surgeon that does work with in network people. Good Luck!
   — Sylvia E.

April 22, 2003
I think that different hospitals handle it different ways. I looked up my claims on the Aetna website and all I ever saw from my stay was a claim from the surgeon and from the hospital. The anesthesiologist and others' fees must have been part of the hospital bill (I never saw an EOB so I am not sure)...JR
   — John Rushton

April 22, 2003
Generally ancillary providers (anestesiologist,pathologist, labs...blah blah blah) are not in network providers. However, most insurance companies pay them in full if the hospital you are admitted to is in network. Check your benefits and you might call them and see.
   — RebeccaP

April 23, 2003
The anesthesiologist was the only one not in my network. The total bill was $1200 which I had to pay half of. Since they were out of network, they were also the only ones who were not contracted under my insurance company so I didn't get any kind of discount (like with my hospital- they wrote-off $19,000!) Unfortunately you probably cannot choose who they use. Contact your surgeons office and ask who they use and go from there so at least you will know. They may tell you they don't know which firm will be used because sometimes there are several working through a hospital. If this is the case, try to find out all that they use and you may find that most are in or out. More than likely you will not find out until after surgery though. Good luck to you!!...Karen (lap rny- 7 months post-op, down 127 pounds!)
   — karmiausnic

Click Here to Return