Cost Anesthesia Cost

[Carole Flower 22]

I thought all my surgery cost were covered after I met my deductible. But I get this bill for anesthesia and I owe them $3,314.60. My health insurance is through Aetna and they just told me this was an out-of- network charge. They have paid some of it but I am left with this balance.The total charge was a little over $6,000. My surgeon is in partnership with other doctors and have an interest in the hospital where my surgery was performed. I spoke with the doctors coordinator and all she could say was "Sorry. I didn't know there were out of network." Sounds a little fishy to me. I have no choose but to pay it. Has anyone else been charged for anesthesia?

[MIJourney 490]

Sorry to hear this. Insurance is not fun to deal with:( Hope someone can help you with this.

[Beach Lover 1,084]

Out of network and they didn't tell you? Seems like your coordinator is at fault with this. Isn't she responsible for coordinating your surgery according to your insurance providers? I would take this further with your doctor because at this point you are responsible and you trusted his people to take care of you. Seems like there has to be some place to take this grievance. I am sorry you have to pay this but it is still cheaper than the $10,500 I had to pay. Good luck and don't let this go!!

[Carole Flower 22]

I did get to leave a message on her voice mail and told her I was thinking about a lawyer but that is silly of me to go there. I need to suck it up and be glad it wasn't more.

[Beach Lover 1,084]

I did get to leave a message on her voice mail and told her I was thinking about a lawyer but that is silly of me to go there. I need to suck it up and be glad it wasn't more.

I have never consulted with a lawyer but we must have one on this forum who might be able to give you some insight into this. I just don't think this should all fall on you. You trusted them to handle it correctly and use an in network provider. That is what she is being paid for. You could also talk to your insurance company and see if they have any advice also.

[Mkak 251]

Carole, I work in insurance and this problem is pretty common. My first recommendation would be to call Aetna. You did your due diligence as the member/patient by selecting a participating (in-network) surgeon and facility. You had no say in the anesthesiologist, so you should not be on the hook for any additional charges (outside of what your charge would have been had they been in-network). You have to be persistent with them, but in the end it should work out in your favor. Feel free to PM me if you would like to discuss further!

[No game 14,437]

anesthesiologists are almost always out of network... It's a tidy little business.

Just google it.

Patients are often surprised by bills after receiving services like anesthesia, pathology and radiology. Those specialists, who don't hang out a shingle and may not rely on ongoing relationships with patients, often avoid signing up with health plans in order to set their own rates.

We have dealt with this many times call your insurance company and if they refuse to cover it call the biller of the

anesthesiologist. Sometimes they will reduce the out cost.

[Beach Lover 1,084]

Carole, I work in insurance and this problem is pretty common. My first recommendation would be to call Aetna. You did your due diligence as the member/patient by selecting a participating (in-network) surgeon and facility. You had no say in the anesthesiologist, so you should not be on the hook for any additional charges (outside of what your charge would have been had they been in-network). You have to be persistent with them, but in the end it should work out in your favor. Feel free to PM me if you would like to discuss further!

I agree 100% If the anesthesiologist was out of network this should have been disclosed to you and it wasn't. You were not informed to make your own decision about this. They spent your money without consulting you. I hope this works out for you! Don't be afraid to be an advocate for yourself!

[Mel1071 149]

Ah, another example of insurance screwing things up. While part of me hates that my insurance company won't cover anything related to WLS, part of me is glad to not have to deal with the BS.

To give you an idea of just how screwed up insurance is - you're being asked to pay ~3K of the 6K anesthesia cost. My self pay rate for anesthesia is $1500 total.

[Beach Lover 1,084]

Ah, another example of insurance screwing things up. While part of me hates that my insurance company won't cover anything related to WLS, part of me is glad to not have to deal with the BS.

To give you an idea of just how screwed up insurance is - you're being asked to pay ~3K of the 6K anesthesia cost. My self pay rate for anesthesia is $1500 total.

So damn true!!!

[ribearty 544]

Carole, I work in insurance and this problem is pretty common. My first recommendation would be to call Aetna. You did your due diligence as the member/patient by selecting a participating (in-network) surgeon and facility. You had no say in the anesthesiologist, so you should not be on the hook for any additional charges (outside of what your charge would have been had they been in-network). You have to be persistent with them, but in the end it should work out in your favor. Feel free to PM me if you would like to discuss further!

Carole, you should be able to appeal this charge. Like Mkak said you had no say over who your anesthesiologist is and they are providing services in an in network hospital. I would also ask them what the payment would be if it was in network then see if the ins. co. will pay that amount.

I run into this a lot at one of the hospitals where I have x-rays taken. The bill is read by an out of network radiologist, but they always accept the amount that my insurance pays because like you I have no say over who is going to provide read and write the x-ray report.

Good luck.

[ctsleeve 20]

I'd call both the hospital and the anesthesia practice. If you mention lawyers, they won't talk to you. Tell them what happened and ask how they expect you to know whether the anesthesiologist is in network if you aren't advised ahead of time. Then ask if *any* of the anesthesiologists at the hospital are covered by your insurance - if the answer is no, your surgical coordinator should have known that and disclosed that to you.

Good luck.

[Carole Flower 22]

I got a call this morning from the Head of Anesthesia at Sugar Land Surgical Hospital and he said “I owe them nothing. “ Wahoo!

I faxed my appeal letter last Friday and I’m so glad I did. They were charging me $3,000 for anesthesia after my health insurance had paid them.

Thanks to everyone for the good advice.

[Beach Lover 1,084]

I got a call this morning from the Head of Anesthesia at Sugar Land Surgical Hospital and he said “I owe them nothing. “ Wahoo!

I faxed my appeal letter last Friday and I’m so glad I did. They were charging me $3,000 for anesthesia after my health insurance had paid them.

Thanks to everyone for the good advice.

Way to go!! I knew if you stood up for yourself it would pay off!! I am so happy for you!! You go girl!!!!

[Sweeteyes27 31]

I thought all my surgery cost were covered after I met my deductible. But I get this bill for anesthesia and I owe them 3' date='314.60. My health insurance is through Aetna and they just told me this was an out-of- network charge. They have paid some of it but I am left with this balance.The total charge was a little over 6,000. My surgeon is in partnership with other doctors and have an interest in the hospital where my surgery was performed. I spoke with the doctors coordinator and all she could say was "Sorry. I didn't know there were out of network." Sounds a little fishy to me. I have no choose but to pay it. Has anyone else been charged for anesthesia?[/quote']

Where did u have ur surgery at if you don't mind me asking?