Hospital Double Dipping??

[4re4me 1]

Hey All,

My insurance Co., Aetna Health Care has approved the cost of removing my band but NOT the sleeve revision. My Dr says he can perform the procedure at the same time. Price will be $8000 for hospital and $1736 for his fee. Total $9736.

I asked about a discount as it seems my insurance company is already paying for hospital, surgeon, anthestiga, etc. They (hospital AND doctor) are telling me no because it is two different procedures even though performed in in the same operation. Has anybody else run into this?? I expect to cover the cost difference and I am sure there are some but this really sounds like I am being double dipped.

[educationrulz 18]

Hey,

I'm no insurance expert but this definitely sounds like it's being driven by the hospital. Since the doctor is going to get his money from you for the second procedure regardless of what the hospital charges, they are the ones who stand to lose. They only get a contracted amount for the insurance covered procedure, so they will make their money from the revision that is not covered by the insurance. I think they are trying to squeeze some money out of you :biggrin2: since the use of the OR for the revision should be included in the procedure to remove the lapband. Maybe you could try calling some other hospitals to see how they would bill for this situation. I've heard of situations where you would only be charged the doctor's fees for the second procedure, so maybe you can find somewhere else to get it done. Good luck!

[valleygirl806 0]

You can also pay for everything yourself, get your medical records and file your claim with the insurance company.....they can't stop you from doing that.