hospital visits are different from clinic visits

來源: cxz2509 於 2015-03-06 14:55:48 [] [博客] [舊帖] [給我悄悄話] 閱讀數 : (594 bytes)
本帖於 2015-03-06 19:23:53 時間, 由普通用戶 cxz2509 編輯
回答: 我也來控訴一下美國的醫療保險 由 宴客 於 2015-03-06 14:41:25

If someone is admitted to the hospital and is seen by the on-call providers/specialists, the insurance has to pay since it is considered as an emergency. You may need to pay a copay for in-network providers, but the insurance should pay 100% for all out-of-network providers in the hospital.

This is different from clinic visits. The insurance can deny the claim if you see an out-of-network doctor in non-emergent situation.

If you have to pay, you only need to pay the amount shown in the EOB (Explanation of Benefits) sent from your insurance company.

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