malinda1229 1 Posted July 28, 2010 I just saw my bill on the Blue Cross web site...did not get anything from the Hospital. $37,412.62 this is the operation, barium swallow, 2 visits with surgon (prior to surgey) visit with PCP. It did not include all my pre-op work that I had done at another hospital with a differnet insurer. SO this does not inclued psy eval, dietian visits, group therapy, sleep apnea and cardiac stress tests!! Thank god for health insurance! Share this post Link to post Share on other sites
Humming Bird 275 Posted July 28, 2010 That is crazy. It is also one reason I can not afford health ins. My surgery was just under $10.000 (included hosp., anes., even the first consult and much more) Why must they charge so much more to the ins. company? Share this post Link to post Share on other sites
Tish5632 0 Posted July 28, 2010 I must agree, this is insane. That's how much a gastric bypass (long-limb meaning long surgical incision) would cost. Another big reason I went to Mexico. My insurance would not cover any WLS and I couldn't afford to be self-pay in the US. I had my surgery on 7/3/09 and I couldn't be happier! :scared2: Share this post Link to post Share on other sites
schwartz26 0 Posted July 28, 2010 I too just got my insurance statement and the total cost was $36,000 I was in shock at the cost...crazy!:scared2: Share this post Link to post Share on other sites
newmein10 0 Posted July 28, 2010 i dont know what type of insurance everyone has but i can speak on what i know being that i work in the industry-make sure you're communicating w/the bariatric office and your insurance. find out what codes they use, if they require auth and that auth is obtained. if auth isnt obtained-yes billing is a lot higher and creates a can of worms. also-make sure to document everything. i recently made my appt for my 1st fill. i have an email w/the codes from the bariatric insurance saying no auth req'd when actually it does for one of the codes. STAY INFORMED! Share this post Link to post Share on other sites
malinda1229 1 Posted July 28, 2010 This was pre-approved and all Billed and paid by Blue Cross. I just feel the amt is was to high when I see what people who self pay is alot less.. so the question here is how can one doc bill $37,000 for a surgery that is covered by insurance and another doc charge $10,000 for those who self pay. This is ONE of the many things wrong with the health system! Share this post Link to post Share on other sites
Taterbugsmom 0 Posted July 28, 2010 OMG! $36000!?!?!?! I recently had surgery and am required to pay 15%, I will die if I open the bill and it is $5400 vs. the $2500 I was expecting to pay! :scared2: Share this post Link to post Share on other sites
sixtythreenova 0 Posted July 28, 2010 Well, don't feel bad, i got my bill through Blue Shield of CA and it's $49,500!! That's just the hospital bill and they say i'm responsible for 25% at a max out of pocket of $3,500. But they included alot of stuff on there i'm questioning.. They included the band alone at a cost of $10,000 and the anethesiologist charges too... This is just crazy! Share this post Link to post Share on other sites
SwissMiss 1 Posted July 28, 2010 (edited) Well I opened my bill the otha day from AETNA and my surgery was $42,906.97!!! I am responsible for 15% of that so my out of pocket portion is $6,485.21. Luckily the business office screwed up on verifying my benefits and caught it the day before my procedure so I didnt have to pay upfront all of that money and am being billed for it. This is just the hospital portion not the DR.'s portion Edited July 28, 2010 by SwissMiss Share this post Link to post Share on other sites
NinaC 0 Posted July 28, 2010 I'm in the industry and just because your bill is $40,000 doesn't mean the insurance gets that much money. They hospital increases the prices for everything with hopes they will get more back. They usually get about 30% of what they bill the insurance. That's how come when we pay out of pocket it's only $15,000. It's so confusing I don't thinik anybody understands it. Just know that the hospital isn't making $40,000 for one surgery. Share this post Link to post Share on other sites
sld21 26 Posted July 28, 2010 I'm in the industry and just because your bill is $40,000 doesn't mean the insurance gets that much money. They hospital increases the prices for everything with hopes they will get more back. They usually get about 30% of what they bill the insurance. That's how come when we pay out of pocket it's only $15,000. It's so confusing I don't thinik anybody understands it. Just know that the hospital isn't making $40,000 for one surgery. I was going to say the same thing. I look at my insurance statements that they send when someone has submitted a claim. The doctor may charge $150 for his office visit but may only get $50 depending on the contract prices that the doctor negotiated with the insurance. Even though self pay seems cheaper, insurance companies are paying self pay prices to the doctors. What gets my goat is to get a .5 of a fill and still pay a specialist copay and the doctor still gets his office visit charge to the insurance. But I can understand for safety of the patient but geez. I have Humana and my surgeon no longer takes my insurance because they wanted to cut him even further. When I do need a checkup or fill (I am at restriction now), I will have to search for another dr or pay out of network fees (which I can't afford). I asked the office what a self-pay fill would cost and they told me $100. Share this post Link to post Share on other sites
Katy Castro 1 Posted July 28, 2010 My bill was just over $36,000 from the hospital plus about $7,000 more from the surgeon and that does not include the anesthesiologist or any of the pre-op stuff. I also had to pay just over $3,000 to the hospital and surgeon prior to surgery. But I have no remaining out of pocket expenses and my fills are covered for the next year so I no longer have to deal with co-payments. Share this post Link to post Share on other sites
onenuttynurse 0 Posted July 28, 2010 i got extremely lucky. I only was expected to pay $900.00 total which included the fist 3 fills. That is what insurance covered including hospital, anesth, and doctor. Oh and I did pay $30.00 every month for 6 months in a row when i was going through my nutrition consults...so total was right or a smigen over 1000.00..... ...Now when i go in for a fill it is $40.00 a fill now....I don't think that is bad at all........ Share this post Link to post Share on other sites
Murpel 0 Posted July 28, 2010 (edited) Wow! I was told at seminar that surgery was $16,000.00 period. I was lucky, my co-pay was $496.00 for surgeon, anist., and first 3 office visits (wound check) and 2 fills, plus $52.00 to the hospital. I paid less than $550.00 for my surgery, and $100 for psych eval. The 4th and beyond office visits / fills are specialist co-pays.:scared2: KatyinLasVegas went to the same surgical group I did. Just amazing! Edited July 28, 2010 by Murpel Share this post Link to post Share on other sites