Self pay

[tracik 62]

Hi. I am having RNY next Tuesday. My insurance company has a specific clause disallowing all WLS. I am self paying 26k out of pocket for this surgery. However, I am getting EOBs from earlier visits for nutrition, lab tests, psych eval that have all been submitted through my insurance company and they are paying those charges! They didn't pay for surgeons visit, but basically everything else. Now, on Thursday, I have to pay my 26k. But they have already been paid for items included in the flat fee. When I asked at the clinic, the lady said, oh well they weren't supposed to charge that through, you are self pay. Duh... I know that. S I told her that her office did. She said it didn't matter. After the procedure they sit down and go through all my charges and if the insurance company paid anything, they will be refunded. I don't believe them. I think they will pocket my money and what the insurance company pays. Anyone ever seen a review post surgery of your account?

Has anyone ever bought Bliss insurance and needed it? Thanks. BTW, this is Cleveland Clinic.

[TinyMamiOf3kids 1,280]

This sucks! You must have a great job to have over 20g for surgery. Took me a long time to save for my boob job then still saving for next year.

Insurance company sucks! Glad your doing this for you. You will feel good. Hope you get some money back from stuff you were cover threw ins.

[ElleG 394]

I have Blue Care Network... They always sent me a copy of the "bill" that they pay. I can also look online to see what has been submitted to them for payment, what they paid and what they rejected

[tracik 62]

This sucks! You must have a great job to have over 20g for surgery. Took me a long time to save for my boob job then still saving for next year.

Insurance company sucks! Glad your doing this for you. You will feel good. Hope you get some money back from stuff you were cover threw ins.

I do have a good job, but I lobbied for over a year to have it added to our plan, but in the end, they would rather pay for obesity related issues for the rest of my life. I saved over that year and now I am ready. I am just not happy about them billing my insurance company and making me pay the entire bill! My surgery is next Tuesday. I am so excited (and scared out of my mind!)

[HeroOfThisStory 24]

Your insurance company is going to send you the same EOB they send the doctor, sans check. If your EOB shows the insurance company paid, the doctor has to issue you a refund or credit. I'd watch your mail closely and read the EOB's even closer.