$60,000????

Sultana · February 28, 2004

Hello All,

I was banded on 12/29/03 and all the bills have been coming in to my insurance, UHC. I have been keeping track on the web, and one was for $19,000+, and I assumed that was the surgery bill even though it was billed as Lenox Hill Hospital. Today I received a statement for FOUR charges of $15,000 each for the surgery. Two were assistant surgery charges and the other two were listed as Laparoscopic Procedure charges. I did e-mail my doctor, Marina Kurian, because they sent the bill to an insurance company that I had to drop so that my husband's UHC would cover the surgery, but COULD THIS BE POSSIBLE that the surgery cost $60,000???? If so, no WONDER we will all have to start kicking in big bucks for health coverage. If UHC pre-approved this surgery, and they did, I will not be stuck with any of this, will I?

Thanks.

Sultana

Alexandra · February 28, 2004

Hi Sultana,

My guess is that at least one of those bills is a duplicate. And, speaking as someone familiar with insurance billing practices, I can tell you that the rest of those bills will be settled at some much smaller amount. For example, if your surgeon bills $15K for a surgery he might actually receive something closer to $5K. There are negotiated rates paid to participating providers, especially when a procedure is routinely covered.

It is always alarming when we see the bills for medical care, indeed. We've gotten so used to the way HMOs work that we have no idea what the actual cost is of any healthcare. And, as another side effect of HMOs, healthcare costs are very uneven. The same procedure will cost one amount when billed to one carrier, something else from a different carrier, and something entirely different if the patient is paying.

None of it makes sense. But the bottom line is that your contract should spell out how your portion of costs are calculated (deductible? hospital copay? in-network coinsurance?) and that will be it.

Sultana · February 28, 2004

Hi Alexandra,

I do know that I determined before surgery that the most I would have to pay if my doctor was not a UHC participant (and Dr. Kurian is not) is $1500. Since the surgery was pre-approved, they can't charge me more than that can they? Perhaps there is a duplication of charges. I do know that there they share procedure codes--two have one code, and the other two have another code. Thanks for your reply. Like you said, it really can be alarming!

How did your fill go? I do not even feel a change with mine. Some days I feel like I never even had this surgery, and I struggle to not GAIN weight. I sure hope things improve.

As always, thanks for your reply.

Sultana

Alexandra · February 28, 2004

My fill was fine, thanks for asking! I'm definitely more restricted than I was before, and happily not so much that I'm getting into trouble. I still get "full" way before I want to be finished eating, so I'm working on that aspect.

It's so hard to have something I used to consider an appetizer before a meal and realize that I'm all done. Now I have to wait while everyone else eats and try not to be jealous.

Sultana · February 29, 2004

Hi Alexandra,

I am so happy to hear that you are finally feeling some real restriction! I can certainly understand that getting used to your appetizer-sized portions might be a little depressing, but I'll bet that when the pounds start coming off, and when it starts to become just the way things are, that it will be a whole lot easier!!

Eating is such a part of any type of socializing (even within the family!), and that definitely requires some adjustment, but when you start to really lose some weight the adjustment will become easier! I suppose that we all have to realize that this is a physical and a mental challenge/change, eh?

I just hope that I will get to the point where you are soon! I am struggling now because I can still eat too much. At this point I feel sortv of like I did when I just couldn't believe that it would ever happen that I would get banded. I feel like I don't even have one. I am trying to believe that it will work out in time and with fills.

Take care.

Sultana