Unbelievable charge for VSG to my insurance

[Bridget312001 70]

I received a statement from my doc's office last week and was completely unprepared for what I saw. My insurance was billed for a VSG and Haetal Hernia repair to the tune of $120,000! Holy ****! When I had asked how much the procedure was going to cost previous to the surgery I was told it would be around $25,000 in total and "not to worry" insurance would pick up the tab. When I contacted the billing department I asked how they could justify this sort of charge the associate said that this was a major surgery and the charge was normal. She also went on to say that just because $120,000 was charged it didn't mean my insurance would pay that amount. I replied that according to the statement the insurance paid the whole amount!!!!

Don't get me wrong. I had an awesome experience from beginning to end with my surgeon and his office staff, but was it all worth that much money? I think not. No wonder our insurance premiums are so much. To add insult to injury the docs office also said I had a balance of $2500 to pay out of pocket (after I was told there would be no out of pocket expense). I flat out told them to pack sand. No way am I paying a damn penny. They have had enough.

I appreciate that I am very lucky to have my insurance pay for this procedure. I just cannot believe the gaul of my doctors office to charge SO much! I wasn't even at the facility for 24 hours!

To give some perspective my boss had a tumor in his stomach and had the equivalent of a VSG with a FIVE DAY hospital stay. His bill in total came to $60,000. Can you see why I'm upset?

[tigerbelle 328]

that is ridiculous for surgery where you stayed just one day in the hospital...you are right that no wonder insurance premiums are so high...glad your surgery went well, though

[MIJourney 490]

Seems quite high.

My Dr and hospital were seperate billings.

I've never seen ins companies pay the full amount of the charges.

Mine paid approx 1/2 of the charges but that amount was accepted as payment in full by the Dr & hospital.

Still my total charged by Dr and hospital for 1 night stay, sleeve & hernia was approx. 35,000.

This didn't include the anesthiologist or pathology which were billed seperately but also covered.

[nyorker 67]

My Dr fee was $10,000. Emblem paid him 1775 lol.. I dont know what the hospital fee was yet.

[Bridget312001 70]

I have two insurances, one through my employer and a second through my husband. Between both of them they paid the full amount.

[RickM 1,752]

Quite normal. As usual, when you see this kind of distortion in the marketplace, you can bet that the government is involved - in this case, Medicare reimbursement practices are a major influence on this hokey accounting. "Normal" charges will be integral with your insurance contract with the providers (which, likewise, are not always the most rational things in the world, either.)

[Pixie Dust 526]

I just received my EOB yesterday & for the sleeve, it was nearly $17,000 & my insurance paid all but $450. From most people I have heard their surgery was around the $20,000 mark. I can't believe yours was $120,000??!!! Wow....maybe they're planning on building a new wing onto the hospital!

[M2G 1,836]

Mine was around $32,000 dollars and I had to pay $5,000 of that out-of-pocket, but I knew that was the deal going in. No matter what the "paperwork" says I can guarantee no one paid that much money. The hospital "discounts" the fee and the money changing hands is not that amount.

Your does seem like an astronomical number...since they are asking you for more money you might want to do a little bit of investigation about the bill. Good luck, I hope you don't have to pay more $$$$...

[Arts137 1,811]

... proof that our insurance 'system' is very broken...

[ChaoticBliss 113]

At self pay my total out of pocket was right at 15k. That's all the little bills and pre op qualifications etc. They still made money on me. That really shows how out if whack insurance is.

[sarsar 824]

That seems like a crazy amount to charge the insurance company. Did you ask the insurance companies why they paid so much?

Curious to know what the doctors office said when you told them you won't be paying the $2500...

[MWilliams42 28]

I received a "bill" yesterday...said I owe -7000.00...why send a bill when I know I owe nothing, paid cash. I looked at the total amount for the surgery, and even though my rate was pre-negotiated, it stated it was $42,000...that is WAY more than my cash price...I didn't know they could up the cost that much, they must do it to see what they can get insurances to pay. Although I didn't pull out my insurance card once, paid cash, no balance billing but I was still shocked at the price. You should really check that out, that seems like they shouldn't have billed both insurances, I'd ask them why they thought they should bill both.

[Bridget312001 70]

That seems like a crazy amount to charge the insurance company. Did you ask the insurance companies why they paid so much?

Curious to know what the doctors office said when you told them you won't be paying the $2500...

The person who writes off balances will be contacting me "soon". I will let you know what happens.

[conemjo 3]

My vsg surgery and 3 day hospital stay was over 250k and this does not include my surgeons fee. Crazy!

[keke 60]

My vsg surgery and 3 day hospital stay was over 250k and this does not include my surgeons fee. Crazy!

Omg that's a lot... Unbelievable