Healthcare Loophole

Wednesday, September 20, 2017

I’m just curious if others out there are experiencing this issue with healthcare. More and more I’m running into situations where facilities are in my insurance network but when I receive the bill I’m informed that the provider was not.  It has happened to me twice in the last few months.

The first case involved my son receiving treatment for a laceration at the Erlanger Medical Center ER. It seems that Erlanger is in the Gilsbar Insurance network, but the ER physician that treated him was not.

The second case involved my wife having a wellness mammogram at Chattanooga Imaging. Again the facility was in network but the physician that read the mammogram was not. In the Chattanooga Imaging case they filed the entire visit under the physician’s ID number so Gilsbar does not want to pay for any of it…..the mammogram or the reading.

I guess now you have to ask every doctor that walks in your room for proof that he/she is in your insurance network. Oh, and if you have a test read by a doctor that you will never meet….well I guess it just the luck of the draw. 

These situations work out well for the insurance companies because they can refuse to pay. It also works out well for the provider because they can bill for the full amount since they are not restricted by an insurance contract. However, the patient (who has no control over the situation) is the one who gets trampled on.

To be honest, it really looks like the insurance companies and the healthcare providers have found a loophole in the insurance laws that they can both benefit from.

Bill Peers 



Re-elect Joe Graham

Early voting time is here again and our choices couldn’t be more important.  It’s an easy choice though for the voters in Hamilton County District 6.  Joe Graham is the obvious choice.  I’ve known Joe for over 40 years.  I grew up with him.  He was a few years behind me at Lookout Valley High School but even then, I could tell there was something special ... (click for more)

Party Problems In The 30th District House Race

Watching the 30th district house race is very interesting.  It is normal that the front runner in an election can expect some attacks.  However, the vicious attacks that Ms. Helton is facing is unprecedented in my opinion.  Both of these candidates are in the same party.  I was under the impression that party leaders were the ones that challenged a candidate’s ... (click for more)

Man Shot And Killed On Arlington Avenue On Wednesday

A man was shot and killed on Wednesday afternoon on Arlington Avenue at the Bayberry Apartments. Chattanooga Police responded around 5 p.m. and found the victim. Officials said it appeared to be the result of a disorder between the suspect and the victim. The investigation is ongoing.   (click for more)

Firefighters Battle 2-Alarm Fire On Workman Road Tuesday Morning

Chattanooga firefighters were dispatched at 6:03 a.m. on Tuesday, to a commercial fire at 400 Workman Road. When the first firefighters arrived on the scene, flames were shooting through the roof and the request was immediately made for a second alarm response. The flames could be seen for miles as a total of 13 fire companies rushed to the scene. The large, two-story ... (click for more)

English, Ex-East Hamilton Coach, Hired To Lead Whites Creek Boys' Hoops Team

Rodney English, former boys’ basketball coach at East Hamilton, recently was named to a similar job at Whites Creek High School in Nashville. The move was made public Monday when English’s name appeared on the official Whites Creek school directory that is annually submitted to the Tennessee Secondary School Athletic Association. The hiring of English at Whites Creek was also ... (click for more)

Vols' Nigel Warrior Named To Bednarik Award Watch List

Tennessee junior defensive back  Nigel Warrior  has been named to the 2018 Bednarik Award Watch List. Warrior is the first Vol to be named to the Bednarik Watch list since the defensive trio of Derek Barnett, Jalen Reeves-Maybin and Cameron Sutton were named to the Bednarik's preliminary list in 2016.   Warrior totaled 83 tackles with 3.5 tackles for loss ... (click for more)