Surgery approved then received $70,000 hospital bill!!

[CherieLynne 0]

I had my lapband surgery at Good Samaritan Hospital in San Jose, CA on Jan 12, 2010. I stayed overnight at the recommendation of my surgeon. All went fine, I've already lost 32 pounds. I am insured through Blue Cross of CA, specifically through the Writers Guild of America. Both approved coverage of my surgery. When I got to the hospital they asked for $5000. My surgeon (Dr. McKeen, who is terrific) told me I would get this back later on. Then a month later I got a hospital bill for services NOT covered by my insurance for $70,000!! Of course I plan to fight this, but any help/insight would be greatly appreciated. Anyone else get blindsided like this? Is it even legal? Didn't someone have to inform me ahead of time if there were going to be significant charges not covered by my insurance? Help!!

[JennBand08 0]

If insurance had covered it, I would have questioned the 5,000 up front at the hospital. I got a bill shortly after my surgery for 10,000 for the assistant surgeon that wasn't a covered provider in my plan( Anthem BC/BS). I called and explained that I did not CHOOSE this assistant, nor did I even know my surgeon required an assistant for the surgery. She asked me questions and said, ok, so this doctor was chosen while you were under anesthesia? I said.. YES!.. They sent it to review and after about 5 weeks I got a letter saying it had been covered. Whew.

I'm sure you're stressed.. but keep calling and arguing with them. Do you have your prior authorization letter with case #? I keep having to fight my insurance because they keep rejecting my fills. But they go to review and then eventually they DO pay them. But what a hassle. Good luck!