Anybody whose insurance paid...

[texaschick 0]

If your insurance paid, do you know how much they paid for the procedure. I know it will vary by location, plan etc, but I am just trying to get an idea of how much the insurance companies are actually paying for the procedure.

If it is less than what I am paying self-pay, then maybe I can persuade my physician to give me a better deal. If I pay up front why shouldn't I get the same rate as an insurance company? They don't have to file the claim, wait for the money, appeal if denied, etc...

[cwalker 12]

mine insurance was to pay 80% but I havent gotten final paperwork yet.

[BeenThereWasThat 2]

Mine will pay 80% after my $750 deductible is met....

Not including my deductible I have a $2000 yearly out of pocket max. I will probably have to pay that before the end of the year.

[Tiffykins 673]

From what a few people on OH put out there, the hospital bill was between 40-100K depending on nights in hospital and leak tests done (radiology charges, equipment etc). Grant it, they won't pay that because that's not the agreed contracted amount. The averages were about 20-40K that an insurance company actually pays.

My band surgery was billed at around 67K, insurance company paid out about 40K. My band doctor billed them $250.00 per fill, he got paid $109.00.

I hope that is what you were asking. For my revision, it was a huge bill.

[texaschick 0]

Thanks all. I was trying to see if the insurance was getting a better price than the self-pay price, but it appears not.