| Health Plans Put Onus on Insured |
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Let the patient beware. Going outside your insurer’s network of preferred doctors or hospitals could be even more hazardous to your financial health than you suspected. The broad investigation that New York’s attorney general announced last week, questioning the “reasonable and customary” calculations on which insurers base reimbursements for out-of-network medical services, raised the lid on a particularly confusing part of the nation’s health care system. For consumers, the issues go beyond whether insurers are underpaying for 15-minute visits to out-of-network doctors. The uncertainties can extend to the vast array of tests, services and even hospitalizations they may encounter on their medical journey — and the puzzle of determining which ones will be considered in network, out of network or paid for at all. Read on
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