went to within network emergency room to be unknowingly seen by a non-covered provider on call. should i have been notified by the emergency room?

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went to within network emergency room to be unknowingly seen by a non-covered provider on call. should i have been notified by the emergency room?

Asked on May 14, 2009 under Insurance Law, Ohio

Answers:

L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

Without knowing the wording of your health insurance policy, it is difficult to answer this question.  Is your policy an HMO?  a PPO?  Typically, if a hospital is in the insurer's network of facilities for emergency care, the individual dr. who treats you at the emergency room is irrelevant.  You should be covered for whoever takes care of you there.  It is not the hospital's responsibility to tell you if the on-call physician is in or out of your insurer's network, and it should not be required to know that.  Subsequent to the emergency room, you should be treated for follow-up care by an in-network provider.


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