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“Hi, my name is Dr. Ima Crook and I’m your anesthesiologist. Do you know what surgery you will be having today?”

“Yeah, liver transplant, appendix removal, and arthroscopic knee surgery.”

“OK, good. We do that so we know we have the right patient. You just can’t trust the paperwork now days!”

“Funny.”

“All right, let’s get you wheeled in here and put you up on the operating table. In a minute we’ll get you the cocktail and you’ll be fast asleep.”

“Excuse me, doc, one last question. Are you a PPO or a non-PPO physician?”

“Um, I’m non-PPO. Why? (Nurse, can you grab me that scalpel?)”

“Well, I just didn’t want to have to pay out of network fees.”

“No problem. I’m sure the surgeon can take over from here without me. It may smart a little, but you’ll be OK.”

“Huh?”

This must be what your insurance company wants you to do minutes before you go into surgery, when you meet the “supporting cast” of the day’s events for the first time. However, even if you aren’t willing to give up your anesthesia, you still might want to watch out for the old “PPO bait and switch.” I wasn’t aware of this a few months ago and it’s starting to bite me in the ass now that I’m beginning to rack up the medical bills. In case you aren’t aware of this healthcare tactic, here is how it works.

You go to a particular hospital because they are in your network or are a part of your PPO plan. If you don’t, you end up paying a ton more, which doesn’t make much sense. However, you find that when you get your bills and insurance statements you are being charged for out of network services. Doctors, consultants, anesthesiologists, labs (they send your blood samples to a non-PPO lab for processing) are all on the list of non-PPO providers. But wait, you went to an in-network hospital! What’s up? The hospital contracted these people and sent your lab work to non-PPO companies and there is really nothing you can do about it. I’ve been haggling with my insurance provider on some of these issues and I have made very little progress.

I don’t know if anyone wants to go to the extreme case of asking insurance questions when you are on the operating table. Nevertheless, if you have any medical work/healthcare issues make sure to ask a lot of questions and find out if all of the people helping you out are part of your insurance plan. If you don’t, it can end up costing you a lot of extra (and unnecessary) money.

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