Report Filed: Los Alamos Medical Center ER Providers Ripping Off Patients and Hospital Acting As Deceptive Gatekeeper Los Alamos New Mexico!!
My complaint is with the ER Physician and Anesthesiologist whose services I was provided by Los Alamos Medical Center for a broken foot and arm, as well as the hospital itself. I went to my only local hospital which is clearly contracted with my insurance company, but just got stuck with a bill from the ER doctor and anesthesiologist who are not contracted and refuse to accept only the usual, customary and reasonable rate that my insurance pays to out-of-network providers. Instead, they greedily took my insurance company’s payment and additionally are balance billing me for the rest of their exorbitant rates. And, what’s really ridiculous is that the ER doctor basically did very little for me and called in an orthopedic surgeon who took care of me (and who, thankfully is contracted with my insurance). Now, when all the insurance payments and adjustments shook out, the ER doctor basically expects to receive more than the orthopedic surgeon accepted (and he did the work). That’s ludicrous. Hospitals should consider themselves gatekeepers, such that if the ER facility is contracted with your insurance, then any provider which THEY present to you should be, as well. It is very misleading and obviously ER patients are under physical DURESS when they sign paperwork upon arrival. There is a reason why legislature against such balance billing had been introduced in multiple states – because it is SHOCKING and WRONG. Shame on Los Alamos Medical Center, not to mention the unscrupulous uncaring ER providers who are making more money DIRECTLY out of the pockets of unfortunate people facing a crisis. What on earth do I have insurance for if it can’t cover me in an emergency? This is crazy and scary. Please change the laws in New Mexico to limit such uncontracted providers to accept the usual, customary and reasonable rates that insurance companies will and do pay and prohibit balance billing. These doctors who operate under the guise of a patient’s hospital that IS contracted with the patient’s insurance company should not be allowed to balance bill a patient over and above what the patient’s insurance company pays them as an out-of-network provider. In my case, I believe that my balance with this billing company should now be zero, as my insurance company has already paid them. It is ridiculous to expect an ER patient to understand any of the paperwork that he/she is signing under duress. Not to mention the fact that this paperwork STILL doesn’t clarify whether or not the ER providers are actually contracted with the patient’s insurance or not, just that they MAY NOT BE. And, if not, there is ZERO indication of how big this person’s bill will be. It is ABSURD and I am deeply shocked at the lack of ethics that ER physicians possess, for they must know VERY WELL what is happening in these situations.