Here's the deal. Most hospital's outsource the staffing of their full time emergency room physicians. You can't really ask if a individual doctor is in or out of network because they are either all in or out of network depending upon your insurance.

The folks that say, call the insurance and appeal are correct. Sometimes, practices will charge an "out of normal business hours" surcharge. Most physician practices will waive this charge if your insurance does not pay, but you HAVE to ask or they won't waive it sometimes.

I had the same thing happen at the Inova Healthplex. I called BCBS and the rep suggested that send a written appeal - which I did. BCBS responded that its not its problem and that I need to appeal to the hospital which I am now trying to do.

Going to the ER for emergency services does not allow for determining if the Dr. on call is an in-network provider. There is no way that the patient would know - but the hospital certainly knows whether the providers are credentialed or not. I am not a sue happy person but if the hospital does not take care of the bill I will definitely pursue a class action suit. It seems from this one posting alone that there are multiple instances of the same problem.

This happened to me at Alexandria Inova Hospital. I needed two emergency surgeries in the middle of the night. I had Cigna insurance and was billed for 50K several weeks later. I filed an appeal. It was annoying. it got denied and then i appealed that it eventually got covered in full. I think they just push back in the hopes that you will cave.

The same thing happens to many babies who go to the NICU including mine. I got a bill saying that the NICU doctors were not covered by my insurance. I appealed it and got it covered. IT was also a headache.

It's so annoying because you obviously have no control in these situations and they are emergencies which are stressful enough on their own. I have heard it happening to other people too.

In the end it gets covered though! keep fighting

Writing a letter to an Inova administrator may also be helpful.

17:32 here -- how did you appeal? Who did you call, what did you say?

Ugh, I had exactly the same thing: a several hundred dollar bill for an ER visit at In ova Healthplex with Fepblue Care first BCBS Basic. It didn't even occur to me to contest it. Now I will.