Plastic surgeon balance billing is a predatory practice that leaves many patients stuck with financial obligations from emergency treatment. Although this topic falls on the periphery of this website’s focus, it often involves aesthetic surgeons. As such, we feel the need to provide commentary on what we feel to be a major problem in today’s American medical system and a possible issue in some other countries, as well.
Most people do not know what balance billing is until they become victims of it. Once the shock wears off, most patients find themselves infuriated by the way they were exploited in hospitals and medical centers nationwide and seek some way of vindicating themselves. Of course, I would be remiss if I did not mention that my family was also victimized by unfair and unethical balanced billing practices due to an unexpected injury.
Breast-Plastic-Surgery.Org has spent a decade advocating for plastic surgery patients and extolling the virtues of aesthetic procedures. We firmly believe that plastic surgery is true mindbody medicine and that plastic surgeons are some of the best doctors in the healthcare field. However, since plastic surgeons are the most common type of doctor to be involved in balance billing scandals, we also feel it is high time that we spoke out against this practice and condemn it for what it is: just barely short of criminal. This discussion focuses on the travesty of balanced billing in the plastic surgery sector of medicine.
What is Plastic Surgeon Balance Billing?
Balanced billing occurs when a patient seeks care at a hospital, most often for some emergency, and is treated by the care team including a plastic surgeon. In virtually all cases, this involves the plastic surgeon being called in to stitch a wound in a visible location, such as the hand or face in order to minimize or prevent scarring. So far, we have a win scenario for the patient, who receives the best quality of care in their own best interest. The patient is not concerned with the cost of care, since they have the benefit of health insurance and have sought care from an institution that accepts their policy coverage. In virtually all cases, the admissions staff at the emergency room will reassure the patient not to worry about the cost, since they accept the coverage and can move forward in treatment.
The patient will receive care and be released. Within several days to several weeks, they will receive a bill in the mail stating an often ridiculous sum of money owed to the treatment facility or to the plastic surgeon themselves. The patient often feels that this is an error and does not even worry about it until multiple bills arrive, each with a more sinister and threatening tone. At some point the patient will call the doctor’s office or hospital and discover the true reality of balanced billing.
Although the hospital accepts the patient’s coverage, the plastic surgeon does not. In fact, few hospital staff plastic surgeons accept ANY type of insurance as standard practice, since it is far more profitable to perpetrate balanced billing against unsuspecting victims in the emergency room. The patient is never informed that this doctor, who often makes them wait a very long time to be seen, does not accept their insurance and that they will be personally responsible for the bills, which are often exorbitant. The worst part is that the law is on the side of these virtual criminals, forcing the patient to pay or face various punitive actions, such as litigation, judgments, liens and a drastic reduction in their credit rating.
Balance Billing Reprimands
People who seek emergency care should be not punished financially just because they have suffered some unfortunate accident leading to injury. In fact, the injury alone is enough suffering without facing ridiculous medical bills that do more to debilitate families than any anatomical trauma ever could.
Instead of being grateful to the surgeon for a job well done and care well received, balanced billing fosters a distrust of medical providers and direct animosity towards the doctor who so greedily seeks even more money, despite being at the very top of the medical pay scale. Of course the doctor does not deal with any of the complaints personally, since they employ heartless staff to handle the many objections in order to not see the collateral damage of their soullessness firsthand. The goal of this article is to cast a bright light on the practice for all to see, including, and especially, the doctors committing balanced billing. You have collectively angered such a large population of patients and we are ready to do something about it. We at Breast-Plastic-Surgery.Org will do anything we can to help, since we find the practice to be inhuman in theory and cruel in application. It is a sad reflection on the true importance of the financial motivations of some within the medical sector, at the direct expense of those who doctors have taken an oath to serve. We are disgusted.
Furthermore, the hospitals who employ these doctors and do nothing to inform or educate patients about the risk of receiving care from any doctor who actively uses balanced billing as a weapon, should be punished legally and certainly boycotted by all patients. Healthcare is a very competitive industry and I suggest that we vote with our wallets, forcing hospitals to change their policy on balanced billing or face our distinct disinterest in their services.
Plastic Surgeon Balance Billing Experiences
There is nothing wrong with receiving an expected bill for services rendered when the patient is fully informed that care might not be covered. This is not the type of balanced billing that is the subject of this essay. The problem comes when the patient is never given any indication that a particular doctor might provide primary care services or support care services (radiologists, physical therapists, etc) and not accept the patient’s insurance plan. The problem is one of disclosure, which raises serious legal and ethical issues for any healthcare facility, especially given the duress of patients in an emergency medical scenario.
My wife injured her pinky finger on her weak hand by having it smashed in a car door. She went to the local hospital where we go for all of our health needs. She was eventually seen in the ER and told that the stitches would be done by a plastic surgeon who “just happened” to be on call (lying in wait for the next victim, more accurately). She was never informed that his services would not be covered and was actually told that her insurance was great coverage and would take care of everything, without worries. Well, the policy should; it costs a literal fortune! She received 2 stitches in the side of her pinky finger, in a non-visible location. Within a couple of weeks, and after the first of her 2 follow-up visits with this same doctor at his private office, the bills started arriving. The total was several THOUSAND dollars for literally 2 minutes of his time to perform 2 stitches. Worse yet, she had complications due to his poor skills and needed even more care after his work was done. This doctor should be ashamed on so many levels. First, he is a top-earner in an industry of top-earners. He also was incompetent in his care and caused complications based on his lack of skill. I made no effort to hold my tongue to tell him exactly what I thought of him. I also contacted the hospital administration and read them the riot act.
Let our experience and the experiences of millions of others countrywide provide warning to all who read this. Balanced billing can happen to anyone at any time. You might be lucky to only owe several thousand dollars. Some people undergo surgery with the “help” of several doctors who do not accept insurance and end up with bills for several hundred thousand dollars. This is financial ruin from which there is simply no escape for most normal people. It devastates lives and only succeeds in making the rich that much richer. Write to your local hospital and demand action against balance billing. Go one step further and contact your local elected representatives and force them into action to protect your rights and safeguard your financial security against this form of legal larceny.
To the doctors who participate in balanced billing in order to maximize their profitability at patient’s expense, your karmic come-uppance is on its way. You might do a charitable act once every few years to cast a positive light on yourself, but the continual exploitation of this little understood loophole in billing policies will have people running from your practice eventually. I hope you suffer the same fate and that it impacts your family in the same catastrophic way it impacted mine.
Readers are welcome to share their own balance billing stories on our social media pages.