This Bill I Got In The Mail Is Bugging Me

[Missmarbe 25]

I recieved a bill in the mail and an EOB from my insurance stating I owe $53,000 for my VSG!!!!!! I called the hospital where I had the surgery , also where I worked until May 8th, and they said that called the insurance and they stated they paid their maximum amount. They also said that some of what I had done was denied. My surgeon's office assured me that they will look into this and resolve then call me back. This is so nerve racking because I wouldn't have had VSG at the time I did because I don't want to have to pay this much for it. If anybody has anybody has any pointers to how to fight this, I will welcome your advice. Between this and student loans, I could have purchased a house!!!!!! I love my sleeve but Gee Whiz!!!

[futureskinnypants 193]

Holy Moly. I've heard about this a few times. Not sure what to do about it. I had this happen with routine labwork with my family doctor. it said i owed 2000, then i called and they lowered it to 300 and some. Hopefully its a big misunderstanding. Makes me glad I didn't use my insurance and did an all inclusive 8000 thing. Let me know what happens, good luck.

[Shilo30 16]

I can't even imagine!! I work for an insurance company.... So I see both sides of it. Have you called the insurance yet? I would suggest calling yourself and finding out what happened... it really could be a billing error. Someone transposes a # and wham! It denies. Try not to completely freak yet until you talk to the insurance. They should be able to explain what happened or what needs to be done to fix it.

I'll keep my fingers crossed for you that its just a mistake!!!!

[WhoozisAnyway 176]

Yikes! I had to fight with my insurance this week, which is unusual because so far they've been great. My hospital EOB said I would owe an additional $500, when I called BCBSIL they said I was being penalized for not calling pre cert just before surgery. However, I HAD called. Luckily my phone log showed the date/time, with that info they"suddenly" found my call and removed the penalty.

Frankly I'm shocked the hospital bill is that high to begin with. That's almost $20k over my EOB.

Sent from my iPad using VST

[Isabel'sGma 18]

As a benefits manager I would do a couple of things.

1) did your Dr get the surgery pre-authorized?

2) are they contracted with your insurance?

3) if the answer to the above two questions is yes, then do not worry about it too much. If the Dr and hospital are contracted, then it is ultimately their responsibility to to the pre-authorization prior to rendering services or it should go back on them. Now, that is the way my plan is designed for my employees and that is not a unique thing.

4) do you have a benefits manager you can talk to about this to help you wade through what might be incorrect information.

[Missmarbe 25]

Sorry I'm replying so late but I just started a new job. I did get pre auth for surgery & I had surgery with this doctor and hospital because it was the only One my insurance would cover. I haven't heard anything and again it is because I haven't had time since my new job. Thanks for all of your help!!!!!