Insurance and self pay conondrum

[crazy stuff 0]

I paid for my sleeve surgery. My surgeon didn't tell me he would charge if I had a hietal hernia. He ended up sending me a bill for $600. I told him I wouldn't pay it and he should check with my insurance. He charged my insurance a ridiculous amount and they sent ME a check for a large amount. Do I need to give him that check or I am only liable for the $600 he is charging me? Personally I don't feel he should get anything. He didn't provide me with any information that I would be charged for such a surgery. Advice???

[kathp 81]

I would check the paperwork on the check they sent you. Then I would carefully pay the next bill from the surgeon and ask for the "paid in full" statement for the account and keep it for your records. If there's a difference, I would keep it, too. As long as the check doesn't require being signed by them or say it's to be handed over, why not? Just don't cause yourself legal issues...

[woo woo 872]

You might want to call the Dr's office and ask about this.

He may have been giving you the self-pay rate for hernia repair, whereas the insurance pay rate could be higher. I think that self-pay patients are often given a break in price.

Better safe than sorry. Also, the insurance company would probably figure it out eventually.

Just my thoughts.

[TeresaRN 57]

In your consent for surgery did it say anything about fixing a hernia?? If not you don't have to pay .most likely you will have I pay. Just give them 20 bucks a month and they can't send you to collections. what a bummer!!