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Not only are they responsible for another 10 - 30% after the deductible, but hidden providers turn negotiated charges into R&C with balance billing. Suddenly the $3000 or so cap on OOP becomes double or triple that.
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Where did you get the 10-30% figure? Online source perhaps?
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I answer a lot of consumer questions in other forums and two of the biggest complaints come in areas that could sometimes be avoided. Serious accidents and major surgery are areas where OON charges seem to hit the most. If you are transported to the hospital in an ambulance, chances are the transport company is a hidden provider, not in any network. As such they are free to charge whatever while your carrier pays R&C.
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What forums are you referring? It would seem the a serious accident would be covered under the "emergency provision" in the coverage certificate. I do not know about other states, but I do know that Maryland has a description of what constitutes an emergency. Would you be kind enough to share with us a scenario or two about the OON surgery costs you referenced?
Thanks.....
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