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St Davids North Austin Medical Center

2.7/4 1 1

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Matt L. | 2016-09-25 20:45:45

The 1 star is for NAMC's use of independent physicians and, in my case, the resulting OUT OF...

2.7 out of 4 stars

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512-901-1000
12221 Mopac Expressway North, Austin, Texas, 78758, USA

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2.7
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Total Rating 1


Nursing Communication
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Doctor Communication
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Pain Management
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Communication Of Medications
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Cleanliness and Quietness
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| NAMC's Use of independent physicians to provide se |  
Show details   | Insurance : United Health Group

Rating Details

Nursing Communication
Doctor Communication
Pain Management
Communication Of Medications
Cleanliness and Quietness
Overall Rating

By Matt L.
on Sep 25 2016 08:09 pm

The 1 star is for NAMC's use of independent physicians and, in my case, the resulting OUT OF NETWORK charges for services while my wife was a patient in the facility. My wife was in the NAMC from May 25 – 28, 2016 for surgery, but the ordeal started out at a local emergency room. The check-in person verified that NAMC was a preferred provider in my insurance network. I thought I was OK from a financial point at that time. The surgery was completed successfully and my wife was discharged. Total out of pocket cost was $3,000 for what I found out later was just for the use of the NAMC facility. Two months later I received a bill from an independent physicians group for 2 visits to my wife in the hospital and discharging her for a total of $1,054 (1/3 of my out of pocket for the entire facility charges). These doctors are out my network and charges were logged against my Out of Network deductible which means I am expected to pay. My insurance company would be paying this if the doctors were in network providers. I read the admittance papers more carefully and found the INSURANCE NETWORK section that said that NAMC uses independent contractors to provide services and that the contractors may not be in my insurance network. I did not notice this at 11:45 pm when I brought my wife into the emergency room in distress, nor was this pointed out to me by the admitting person. What choice did I have at that time? I couldn’t call around and question other hospitals about their practices for providing medical services. NAMC practices in this regard do nothing to protect the patients from unreasonable charges or try to keep the ever-increasing medical costs down. It is also impractical to monitor all services while in NAMC and make sure that providers are in my insurance network. This is basically “you get what you get and don’t have a fit” with no choice available to the patient. It would not be a defense if NAMC said that every hospital does this. Just because everyone does something does not make it right. My question to NAMC is: Do you get a portion of fees back for letting independent physicians practice at the facility? Maybe not for each billing, but perhaps a general access charge? I have a proposal to NAMC to settle this. My in network portion is typically 1/3 of the fees charged. My proposal is for NAMC to pay $666 and I pay the remainder of the $1,054.

 
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