re: The story about anesthesia insurance coverage is a lot more complicated than it looks

“Also, she was "out of network" even though my ENT was "in-network".”

There’s the problem. Out of network doesn’t have a negotiated reimbursement with your insurance company so they are expected to pay the billed amount but usually negotiate a lower amount.

Average collection from an in network insurance company is $200-$300 for tubes in a child and about $100-$150 from Medicaid. If most MDs and CRNAs were making $1500 from tubes then they would do 3 of those 30 minute cases and call it a day and make more than the surgeon. That’s an outlier event.

The surgeon fee was less than the anesthesia in this case, definitely. I think it was $350. It was surprisingly the lowest of all the bills that trickled in after the procedure. Don't get me started on the facility fee snafu.

ETA frick it.

Dr was in network. He had recently opened his own practice. His practice hadn't yet been onboarded as an in-network facility. And I got a bill for $35,000 for out of network facility for the tubes.

I posted a long thread about it here, it was about 7 years ago.