Physical Wellness

Drive-by Healthcare Proving Costly for Patients and Insurers

By Peter R | Update Date: Sep 23, 2014 06:14 PM EDT

An emerging medical practice involving out-of-network doctors to charge patients as much as 40 times the normal cost, is causing concern among patients and insurers.

Sparking off debate over the questionable practice, a New Yorker Peter Drier revealed that he received a shocking $ 117,000 billing from an out-of-network surgeon he had never met. The assistant surgeon, Dr. Harrison Mu of Jamaica Hospital Medical Center in Queens, had offered services to Drier's primary surgeon. Drier was operated last December for herniated disk, IB Times reported.

"I thought I understood the risks. But this was just so wrong - I had no choice and no negotiating power," 37-year old Drier said.

The phenomenon is what insurers called drive-by doctoring, where out-of-network professionals are roped in by healthcare providers when not required, often to overcharge patients who are not aware of surprise charges. Primary healthcare professionals covered by the insurer and their out-of-network affiliates often share profits.

In Drier's case however, his primary surgeon Dr. Nathaniel L. Tindel confirmed he does not share profits with Dr. Mu. Tindel and eventually agreed to a negotiated payment of $ 6,200, Tech Times reported.

It was later found that the services Dr. provided could have been provided by a trained resident employed at the hospital, but Drier's records show that Mu was called as no qualified extra hands were available at the time of his surgery.

Insurers on their part say the practice has become increasingly common and addressing them often means running into a thicket of financial interests. They add that law suits are being filled against doctors levying surprise charges.

"This has gotten really bad, and it's wrong. But when you try to address it as a policy maker, you run into a hornet's nest of financial interests," said James J Donelon, the Republican insurance commissioner of Louisiana, according to The Times of India.

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