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Paying Till It Hurts

Costs Can Go Up Fast When E.R. Is in Network but the Doctors Are Not

Luke Adami with his father, Greg. The Adamis took Luke to a hospital that was in their insurance network. Credit Ozier Muhammad/The New York Times

Luke Adami with his father, Greg. The Adamis took Luke to a hospital that was in their insurance network. Credit Ozier Muhammad/The New York Times

by ELISABETH ROSENTHAL
For the New York Times, 9-29-14

hen Jennifer Hopper raced to the emergency room after her husband, Craig, took a baseball in the face, she made sure they went to a hospital in their insurance network in Texas. So when they got a $937 bill from the emergency room doctor, she called the insurer, assuming it was in error.

But the bill was correct: UnitedHealthcare, the insurance company, had paid its customary fee of $151.02 and expected the Hoppers to pay the remaining $785.98, because the doctor at Seton Northwest Hospital in Austin did not participate in their network.

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