Pay For Every Fill?

[Sara75 8]

I had my surgery last week but haven't gotten a fill yet. I see so many of you going in and getting multiple fills or having some taken out. Does it cost everytime? I have BCBS Anthem and haven't checked if I get any free fills or if I have to pay from fill #1.

[Grider 92]

I just posted about fills and insurance companies,,, get your information, Could run you $100 a fill- so find out.

[kah1213 311]

I am self-pay and I was told by my doc's office that I'll be paying for each fill.

[NWgirl 574]

I have Anthem BCBS. If you have not met your out of pocket max for the year (or don't have one) then you will be required to pay whatever perecentage the insurance requires.

[kbliss78 123]

Each insurance is different as we as Dr office. For me, I was self pay. I paid one lump sum to the Dr. It will cover everything at the hospital, pre opt, and one full year of post opt and fills. Aftter that, I pay $125 for fill or unfill.

If insurance (BCBS of TX) had approved me, they would have paid $5000 of the proceedure, I would have had to pay $2500 co-pay plus 20% of the remainding surguery balance and for all of my own aftercare. It added up that if insurance paid, it would have cost me $8500 and if I was self pay it would be $1000.00. I ended up going self pay b/c I fought insurance fo 5 years. I was done with it.

Not sure if that helped.

[JennyBee 340]

I have to pay $200 a pop!!! I hope I don't need too many more!

[shues138 35]

It depends on your insurance company and your contract with them. For example I have Anthem BC/BS of CT and my benefits for specialist copays are $30 a visit. My band doctor is considered a specialist so I pay $30 every appointment.

If you have insurance, call the customer service number on the back of the card to ask what your responsiblity would be for an office visit/fill. Sometimes it's a deductable or a copay. No person's contract is the same (unless you have the same employer lol).

Also, if you don't get a good answer from your insurance company, call the md's office because they will want to get the benefits as well so that they will get paid in a timely fashion.

[shortishelli 14]

I had my surgery last week but haven't gotten a fill yet. I see so many of you going in and getting multiple fills or having some taken out. Does it cost everytime? I have BCBS Anthem and haven't checked if I get any free fills or if I have to pay from fill #1.

I have BCBS also, I pay $15 each time I come in, regardless what Ira for.

[Grider 92]

my surgeons codes adjustments or fills as surgery... 150 co pay on any surgery for me BCBS fed

[TX-Techman 0]

I am extremely upset at the tactics of the surgeon (Dr David Kim) that my wife and I used for our surgeries. I also want to warn you all about Forest Park Medical Center where Dr Kim did a revision to gastric bypass on me. In 2009 the hospital charges to my insurance alone was $158,000. The sad thing is my insurance paid 100% of the fees becasue we had met our max out of pocket. I had not really had any issues with Dr Kim until a fill my wife recently had done. The link below is a link the the charges that were submitted to my insurance in the ammount of $1,878. We are on a high deductible plan, but the insurance allowed $623.54 and the doctor wrote it down to $194 which is what we were billed.

Now that may be perfectly alright for some, but to me in addition to being grossly overcharged for the service this is insurance fraud. I actually filed fraud complaints against FPMC after my surgery with the insurance companies fraud department and Texas Attorney General but nothing ever happened.

Healthcare in America is broken and I am not sure how these folks sleep at night. Even if insurance pays these ridiculous charges, it will come back and bite us all.

Our son is in his 3rd year of medical school, I agree physicians should be rewarded with large salaries, benifits... But if you have had this proceedure you know these charges are not ligitimate. We will be shopping around for another provider but wanted you all to be aware.

Insurance Statement attached, read it and take note.

[Lacey8724 38]

Each insurance is different as we as Dr office. For me' date=' I was self pay. I paid one lump sum to the Dr. It will cover everything at the hospital, pre opt, and one full year of post opt and fills. Aftter that, I pay 125 for fill or unfill.

If insurance (BCBS of TX) had approved me, they would have paid 5000 of the proceedure, I would have had to pay 2500 co-pay plus 20% of the remainding surguery balance and for all of my own aftercare. It added up that if insurance paid, it would have cost me 8500 and if I was self pay it would be 1000.00. I ended up going self pay b/c I fought insurance fo 5 years. I was done with it.

Not sure if that helped.[/quote']

Weird. I have bcbs of Texas and I only have to pay 150 for the surgery. But my dad has a government job, maybe that's why?

[NWgirl 574]

I am extremely upset at the tactics of the surgeon (Dr David Kim) that my wife and I used for our surgeries. I also want to warn you all about Forest Park Medical Center where Dr Kim did a revision to gastric bypass on me. In 2009 the hospital charges to my insurance alone was $158,000. The sad thing is my insurance paid 100% of the fees becasue we had met our max out of pocket. I had not really had any issues with Dr Kim until a fill my wife recently had done. The link below is a link the the charges that were submitted to my insurance in the ammount of $1,878. We are on a high deductible plan, but the insurance allowed $623.54 and the doctor wrote it down to $194 which is what we were billed.

Now that may be perfectly alright for some, but to me in addition to being grossly overcharged for the service this is insurance fraud. I actually filed fraud complaints against FPMC after my surgery with the insurance companies fraud department and Texas Attorney General but nothing ever happened.

Healthcare in America is broken and I am not sure how these folks sleep at night. Even if insurance pays these ridiculous charges, it will come back and bite us all.

Our son is in his 3rd year of medical school, I agree physicians should be rewarded with large salaries, benifits... But if you have had this proceedure you know these charges are not ligitimate. We will be shopping around for another provider but wanted you all to be aware.

Insurance Statement attached, read it and take note.

It looks like there was more than just a fill- barium swallow, fill under fluoroscope? I agree the bill seems high, as my barium swallow and surgeon fee was about 8-900 dollars...

[TX-Techman 0]

No it was actually to take 1 cc out! I have not talked to his office yet but think they are multiplying by the days of the week you come in, Mon * 2, Tues * 3, Wed * 4, .... I would like to make $1800 an hour! If we had met my wife's $2000 deductible the insurance would have paid the full amount without question. There are crooks in this business! Beware!

[SageTracey 608]

I'm Australian and all my fills are fully covered under our government healthcare scheme.

[Sara75 8]

Thanks to everyone for your input. I think I've met my out of pocket max so no out of pocket for me.

TX-Techman- that's insane and it angers me. I think it's great that you've filed a complaint and I hope they get busted. I don't know how they sleep at night either.