<story><title>California&apos;s ‘Surprise’ Billing Law Is Protecting Patients and Angering Doctors</title><url>https://www.nytimes.com/2019/09/26/upshot/california-surprise-medical-billing-law-effects.html</url></story><parent_chain><item><author>DollarGuru</author><text>I&amp;#x27;m not familiar with US healthcare. As the customer in such a circumstance are you within your rights to refuse any such diagnosis tests when you reasonably believe they are unnecessary? e.g you have prior history of those symptoms.&lt;p&gt;I have heard stories of some doctors and consultants making biased recommendations that are ultimately to line their pockets not cure the patient.</text></item><item><author>munk-a</author><text>Oh, while I had mono and was pretty delusional my doctor sent me for an cat scan to make sure I didn&amp;#x27;t have appendicitis - 4000 dollars later... yup, just mono.  And I was on vacation at the time and out of network so... fun.</text></item><item><author>coolspot</author><text>I once got a surprise bill from in-network ER because they invited a specialist for consultation, That specialist sent me a separate bill later.&lt;p&gt;No one told me upfront it will cost additional $450 to hear from the specialist that &amp;quot;sometimes kids are having stomach pain for no any reason&amp;quot;.&lt;p&gt;Edit: Additional information - Blue Shield CA HMO, Cedars-Sinai ER , circa 2012. $150 ER co-pay, later $10,000 bill fully paid by insurance + $450 specialist bill not covered by insurance.</text></item></parent_chain><comment><author>fragmede</author><text>Yes, you can refuse testing that you
recognize as superfluous, but, well, I&amp;#x27;m not a doctor, they are. More often it goes the other way - eg most of the time I request a test that WebMD has convinced me will tell me that I don&amp;#x27;t have, well, cancer, and doctors are willing to oblige, but only at my behest. Serina Williams famously almost died because her doctor didn&amp;#x27;t think a test was warranted. Her advocate had to lobby the doctor to run a test which led to a diagnosis that saved her life. (A combination of racism and sexism certainly played a part there.)&lt;p&gt;The problem is that the profit motive is hard to deny, simply because healthcare is run as a profit seeking venture, which makes money on the difference between the cost of running a test and the price a patient&amp;#x27;s insurance will pay. Pharmaceutical companies bribing doctors to prescribe specific medication doesn&amp;#x27;t help.</text></comment>
<story><title>California&apos;s ‘Surprise’ Billing Law Is Protecting Patients and Angering Doctors</title><url>https://www.nytimes.com/2019/09/26/upshot/california-surprise-medical-billing-law-effects.html</url></story><parent_chain><item><author>DollarGuru</author><text>I&amp;#x27;m not familiar with US healthcare. As the customer in such a circumstance are you within your rights to refuse any such diagnosis tests when you reasonably believe they are unnecessary? e.g you have prior history of those symptoms.&lt;p&gt;I have heard stories of some doctors and consultants making biased recommendations that are ultimately to line their pockets not cure the patient.</text></item><item><author>munk-a</author><text>Oh, while I had mono and was pretty delusional my doctor sent me for an cat scan to make sure I didn&amp;#x27;t have appendicitis - 4000 dollars later... yup, just mono.  And I was on vacation at the time and out of network so... fun.</text></item><item><author>coolspot</author><text>I once got a surprise bill from in-network ER because they invited a specialist for consultation, That specialist sent me a separate bill later.&lt;p&gt;No one told me upfront it will cost additional $450 to hear from the specialist that &amp;quot;sometimes kids are having stomach pain for no any reason&amp;quot;.&lt;p&gt;Edit: Additional information - Blue Shield CA HMO, Cedars-Sinai ER , circa 2012. $150 ER co-pay, later $10,000 bill fully paid by insurance + $450 specialist bill not covered by insurance.</text></item></parent_chain><comment><author>snagglegaggle</author><text>These out-of-network bills have successfully been challenged and a law passed to address them in NY (&lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;www.dfs.ny.gov&amp;#x2F;insurance&amp;#x2F;health&amp;#x2F;OON_guidance.htm;&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;www.dfs.ny.gov&amp;#x2F;insurance&amp;#x2F;health&amp;#x2F;OON_guidance.htm;&lt;/a&gt; I think).&lt;p&gt;But, in the first place, these bills were never really valid: in no other market am I informed of the cost &lt;i&gt;after&lt;/i&gt; I have received services. This fact is why the law was passed, though it shouldn&amp;#x27;t need to have been passed. The &amp;quot;contract&amp;quot; is already unenforceable.</text></comment>