My question involves collection proceedings in the State of: ohio
Hello, there's probably several fascets to this case, and I dont know what direction to take. I've taked to 3 local lawfirms here and they dismiss me within a minute of trying to explain the situation.. Cannot seem to find good help now a days.
A few months ago my wife passed out at a bar and fell down and broke her jaw in 3 places and 20some teeth. They rushed her to the ER because she loss consciousness again and obviously had a broken jaw. She had to have immediate surgery that evening in the OR to get her bones reset, a plate put in, and her jaw wired shut. This was done at an in network hospital (biggest hospital in this city) through my insurer (Anthem). My policy is pretty simple, i pay 7,000$/yr deductible, they pay 100% of all in-network charges after that.
So the hospital bill for 4 days and all related work came out to 50,000$ and I paid my 7000 to various people.. A couple months later I get a bill from the surgeon that performed the jaw reset and wirring shut. Apparently he's not an "in-network" surgeon. Even though I was at an in-network hospital, he didn't tell me before he did the surgery he wasnt in-network, and certainly didn't tell me what he was going to charge.. His bill is 18,000$ for the procedure. Now that doesn't include materials, the metal, the other surgeons in the room, the anesthesiologist, the room itself, all other charges were seperate on the main hospital bill. This bill is simply for his time in the room. He didn't remove any teeth (he left them in there, like a a**), he didnt do anything else. I know when he arrived at the hospital because we were waiting in the OR prep room for him, and i know when he came out and said we're done, he was there working for no more then 3-3.5hours. That means he's charging almost 6,000$/hr for this work!
I go to my insurance company and ask them to pay on this bill because i was at an in-network hospital, it was an emergency, i had no option of surgeons, at a in-network hospital. They come back and say we'll agree to pay the surgeon what we wouldve paid any of our in-network surgeons for the same procedure - which is 1,800$. Which sounds a bit low, but still not bad, 600$/hr. i'm sure is a decent rate for a maxiofacial surgeon. However it's 1/10th what this guy is trying to charge me. He is unwilling to drop the price at all, unwilling to negotiate down at all (and certainly not down to 16,000$ less then what hes charging). He's already sent it into collections because I told him I couldn't pay it. I don't even want to pay him 1$ a month, he is screwing us over blind.
There has to be some legal protection right? A doctor cannot just charge whatever he wants, cannot charge 10x more then what the procedure should be, and cannot disclose that kind of information up front, right?? I figured there has to be something i can do legally to fight this? Whats to stop the doctor from charging me 100,000$/hr if he can charge me 6,000$/hr. What kind of lawyer do i need to talk to? All the medical and insurance lawyers ive spoken to were useless, and said they couldnt help me.
I fear if i dont pay on this in the next month or so i'm going to get sued. And my only other option is bankruptcy, considering i depleted my savings paying off the rest of the bills from this accident.
Please help with any advise!