Doctors in New jersey

Christine · May 30, 2004

Hello! I thought I was doing well. I have Blue Cross/Blue Shield POS they approved my surgery. I had my surgery and the doctor submitted the bill for $6,000.00 The insurance paid him $800+. I did not realize that when you go out of Network the insurance over 80% of the amnt they approve for the surgery which is $1.018 and I am responsible for the rest. Needless to say, I receive a bill from the doctor for $6,000.00. I am so upset. Of course the bill is so high because I've also had a fill. The last time I went to his office he would not give me a fill and beleive me I still have quite the appetite. I called my insurance they told me I should consider switching doctors so that they pay for the visit and fills going forward. If I consider this, how would I go about finding a doctor? Would it be a surgeon or a gastroentrologist. I would like to have my husbands surgeon Dr. Sugarman in Bound Brook but he does not do the surgery.

Any ideas?

Christine

:think

Alexandra · May 30, 2004

Hi Christine,

Wow, what a nasty surprise? But you didn't know that your doctor was out of network? That seems like the first thing he should have told you. Was your hospital in-network?? You may get a big hospital bill, if not. I sure hope it was!!

My suggestion would be to look up the names Abkin, Bertha, Borao, Trivedi (and any other NJ lap surgeon's names you can find), on Horizon's website to see if they're participating. I don't know how readily they'll take on the aftercare of another surgeon's patient, but everyone understands insurance hassles and you might get lucky.

For more NJ surgeon's names you can contact Inamed; look on their website for a list (www.inamed.com). Good luck!!

ihvbzs · June 1, 2004

Hi Christine, I am in NJ and my DR is wonderful and has an excellent reputation in this field of weight loss. Dr Borao & his office staff are just GREAT. I have horizon B/S & B/C and have only paid $33. out of pocket . I have also had one fill and so far no bills for that either. I know he takes patients from other DR.s because we have had a couple at our support meeting who orignally had surgery up north and has changed to DR Borao for fills. He is located in Long Branch and has a Baratric center located in the medical offices at Monmouth Medical Center. His phone # is 732-923-6070. It is so important to feel comfortable with a DR and I am sure he would be worth the distance traveled. Good Luck to you.

Christine · June 1, 2004

Thank you so much. I think that I am definetly going to have to start looking. I do not have all this money. I just receive the bill from the hospital. Hopefully that works out ok. I will keep my fingers crossed.

Thanks again for all the leads. I told my doctor last time I saw him that I was going to use the websites as my support. He agreed since the support group I usually go to is geared towards Gastric Bypass, as well as it should. Eveyone there has had one. I am so thankful to have all of you.

Thanks again,

Christine

Alexandra · June 1, 2004

Christine, if you got a bill for the hospital don't just cave in and pay if you thought the hospital was in-network. You can't be held responsible for the whole bill even if your doc was out-of-network. This is a NJ state regulation, so don't let anyone tell you otherwise.

Good luck!!