Out of pocket with hospital

[kng39212 33]

Ok I my insurance pays 80/20 and I have out of pocket max of 1500. I have to pay surgeon 800. How does the hospital bill will I have to pay them upfront or what???

The most I can pay out is 1500 but I just want to know and they are busy and I've left voicemails no callbacks

[line-dancer 810]

when you have insurance there should be no upfront payments.

[mrsto 2,925]

I have insurance, and the hospital required my full deductible up front. I paid them the $3,000, and they refunded the difference after insurance paid.

I had to pay a $1,500 fee up front to my doctor, but that wasn't for the surgery. It covers the first year of aftercare; including fills. Insurance doesn't cover that fee, but it is what it is.... With all the subsequent office visits, I haven't laid out a dime. I don't know that this works out better at the end of a year, but that is the way they have it wired.

kng - ask if the hospital and doctor if they accept Care Credit. It's a credit card ONLY for medical use, and they give you anywhere from 6 to 18 months to pay it off without interest. I didn't use it for my surgery, but I've used it for eye surgery and dental work. It's nice to have some breathing room to pay it off, without being dinged with a finance charge.

[kng39212 33]

Ok I thought so but my surgeon is asking for 800 upfront

[kng39212 33]

So if my deductible is 300 but my out of pocket max is 1500. What I'm I looking at paying up front is what's confusing will the 800 the surgeon is charging me go towards that or will I have to pay him 800 and the hosp 1500?

[mrsto 2,925]

You will have to discuss this with both your doctor and the hospital. But based on what I went through, my guess is that you will have to pay each the upfront fee they're requesting, and then they will refund you once the insurance pays.

I've had a few surgeries, and every time they all want the maximum out of pocket up front. It's THEIR insurance that they won't get stuck with a large patient balance; one that they either never collect, or it takes them years as the small payments trickle in.

[KAATNS 1,473]

I work for a healthcare system and we require pre-payment for elective procedures. Does your doctor have someone in their office that handles surgery scheduling or billing that you could call?

[stept04 465]

My insurance is 80/20 and I did not have to pay the Dr. anything upfront, and as far as the hospital they allowed a 300.00 down payment and then payments on the rest which was 1200 dollars because I already had another surgery this year and my deductible was lower because of it. Before that first surgery the lap-band surgery was going to be a deductible of 3000 and they were not going to allow a down payment, so it seems like what Mrsinto said they don't want to get stuck with a big bill. May be if you put down a big down payment they will consider payments. Good luck

~~~Stephanie

[kng39212 33]

Thanks guys! I spoke with the hosp and got everything taken care of. I've saving for this surgery all year just didn't want to have to delay it any more. But I'm good surgery day is still 7/2/13 830am ☺☺☺