BCBSIL does not pay for assistant surgeon

[MeMeMEEE 206]

I was told by co-workers that had RNY that the Dr bills as co-surgeon which should pay - however mine is showing assistant surgeon so I owe 1687.00. Which is fine I guess, can't do anything about it now. I am not sure when this changed but they do NOT pay for the assistant surgeon. I knew this going in (I work for them) but as I mentioned co-workers who have had the same Dr do RNY says he bills as co-surgeon. Not on VSG apparently.

[longer-life 139]

Do all doctors have/need an assistant surgeon? Why would your surgeon use one if your insurance doesn't pay for it? At minimum you should have been told beforehand, right? Seems you found out through co-workers.

Is this something we have to all find out now?

[MeMeMEEE 206]

My Doctors do all surgeries as co-surgeons. For whatever reason they don't bill it that way. It is a recent coding change that a co-worker came across - there are "bits" on most codes and one co-worker noticed within the last few months it had changed for VSG. They still pay for a assistant surgeon on RNY but not VSG. I called my Dr's office and they had no idea. Of course BCBSIL changed in March from 3 to 6 months so many have been delayed in surgery and I know I was in the first wave of ones to finally get approved again. I am calling today to see how they billed - my RNY friends insisted theirs were all billed as co-surgeon and paid (different code used).

I'm not mad at my Dr, this is a warning to everyone who has BCBSIL to check in to what your dr does.

[SunnyinSD 0]

Good to know. I also have BCBSIL and had surgery on the same day as you. I've only seen the bill for the anesthesiologist (all paid), not for the surgeon yet, but I'll be on the lookout for it. Maybe that's why it's taking so long for my claim to show up as paid. Maybe my doctor's office is going back and doing some revising of the coding.