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Insurance problems amazing

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Mr. Campbell has a very good point in his letter. However, I have found that it is often the insurance companies' fault that the patient (or parent) is burdened with higher co-pay amounts under these "out-of-network" arrangements.

We have had similar situations at Primary Children's Hospital. One in particular that stands out occurred when my 1-year-old son swallowed a penny, which lodged in his esophagus.

After the doctors at the local emergency room were unable to remove it, we were sent to Primary Children's Medical Center's emergency room, where their radiologist tried to remove it, and when that was unsuccessful, my son was taken to surgery.

Now, mind you, this was an emergency situation. Yet when the bills came in, some had been paid by, or denied by, the insurance as "out-of-network."

I was told by the insurance representative that I should have made sure that the doctors treating my son were covered providers. My reply was that if I have taken my child to a covered facility, then the doctors I see there should be covered as well, especially in an emergency situation!

It should not be my responsibility to interview every doctor who goes near my son as to his insurance paneling and acceptance.

As it turned out, my insurance company did not, and still does not, contract with any of the radiologists and very few of the anesthesiologists at PCMC. This makes no sense.

If my child has an X-ray at Primary, that is fine with my insurance, Primary is a covered facility — but the radiologists who read those films, (and whom I have no other choice but to use, because those radiologists are contracted with PCMC) are not covered providers.

Likewise, if my child has surgery in a covered hospital, with a covered surgeon, they can deny the anesthesiology bill, because that doctor was not contracted with them.

I successfully appealed that claim and have appealed others successfully as well. It just amazes me that the insurance companies can get away with this insanity, time after time.

April Harlow