FINANCIALS ?

[BetterNai88 54]

I'm very ANNOYED. My initial consultation was on 01/28/14 and my surgeon's office still has not discussed financials.... what I'm paying...... what my insurance is paying..... When what needs to be paid..... NOTHING..... I called this morning and left a message

[SandeeD 363]

How about my surgery is on Tuesday and the hospital just called and told me that I have to pay my entire $2,000 deductible on Tuesday before surgery. After I freaked out, I told her I don't have it and that's not what I was told. She said, ok pay $250 and we'll bill you for the rest, but you can make a payment arrangement. Nowadays the hospitals are asking for the deductible up front because they've been stiffed too much by people who don't pay theirs. I understand, it's not charity, it's a business, but damn, springing that on people at the last minute is not cool. I know that I'm going to be getting loads of bills from the hospital, the anesthesiologist, the surgeon, etc., but I don't care. Nothing, and I mean NOTHING is going to keep me from my surgery on Tuesday. I'll be paying bills until I die, but with this surgery I'll be paying bills much longer and that's ok with me:)

Edited February 21, 2014 by SandeeD

[BetterNai88 54]

How about my surgery is on Tuesday and the hospital just called and told me that I have to pay my entire $2,000 deductible on Tuesday before surgery. After I freaked out, I told her I don't have it and that's not what I was told. She said, ok pay $250 and we'll bill you for the rest, but you can make a payment arrangement. I understand, it's not charity, it's a business, but damn, springing that on people at the last minute is not cool. I know that I'm going to be getting loads of bills from the hospital, the anesthesiologist, the surgeon, etc., but I don't care. Nothing, and I mean NOTHING is going to keep me from my surgery on Tuesday. I'll be paying bills until I die, but with this surgery I'll be paying bills much longer and that's ok with me:)

Well first off CONNNGGRRAATTSS!!!! 2NDLY that is ridiculous to just throw that on someone a few days before their surgery but I'm glad you were able to work it out. That's what I don't want to happen I would like to know in advance so I can prepare financially also. I have appointments M-W of next week and I'm going to ask every day I'm there until I get some answers.

Edited February 21, 2014 by DonaiA

[erp 2,016]

None of this is sprung on anyone. Read your policy or call your insurance in advance, they will disclose all fees, deductibles and copays. Hope it will work out for you.

[BetterNai88 54]

None of this is sprung on anyone. Read your policy or call your insurance in advance, they will disclose all fees, deductibles and copays. Hope it will work out for you.

I've already spoken with my insurance company that is not the issue as my surgeon's office are they not supposed to discuss financials with me. According to my insurance company my deductible has already been met and I'm only $300 away from my out of pocket maximum but as to who that deductible and out of pocket maximum is paid to and when they directed me to my surgeon's office.

[mmhutch 28]

I am always hesitant to pay a lot of money up front for surgery due to the deductible. For example, my daughter is having knee surgery today and the hospital said we would owe $1300 remainder of her deductible. I told them that I would pay $75 today because the Anesthesiology group are always first to bill and I know we will owe them at least $1000. And I don't want to have to wait 6 weeks to be refunded by the hospital for my overpayment. They said OK and took my $75 payment.

[Dawn2680 30]

SandeeD- I'm grateful for your post. I know that my insurance (UHC) will have a pretty heavy deductible. I go to meet with my surgeon on Wednesday morning and even though I have a ways to go, I've been concerned about the financial part if this journey. Thank you so much for saying what my head has been thinking.

[Jersrose43 837]

I have a $5000 deductible and when surgeon said I had to pay him before hand I told him to stuff it and found a new doc.

All the visits and prep for surgery have come pretty close to eating the deductible

I won't pay anyone a dime until i see my EOB from my insurance to tell me how much and who got charged the deductible.

[jtickle 295]

I don't understand why so many people are shocked by the fact they have to pay the surgeon up front or pay their deductible up front. The surgeon usually has an up front fee. I am have had six surgeries and have always had to pay an fee before surgery. Sometimes they would send it back to me, sometimes they wouldn't. I'm just glad I have met my deductible and out of pocket before my wls. Not trying to be rude, but some of you obviously don't understand how insurance works, give them a call they can explain everything to you.

[BetterNai88 54]

I don't understand why so many people are shocked by the fact they have to pay the surgeon up front or pay their deductible up front. The surgeon usually has an up front fee. I am have had six surgeries and have always had to pay an fee before surgery. Sometimes they would send it back to me, sometimes they wouldn't. I'm just glad I have met my deductible and out of pocket before my wls. Not trying to be rude, but some of you obviously don't understand how insurance works, give them a call they can explain everything to you.

Well being that I am the one that posted it my issue was that 2 months into the process financials still had not been discussed by my surgeon's office advising me what or when I needed to pay not the fact that I had to pay. My insurance company can't tell me what the surgeon or hospital fee is or when they require it only what my policy covers, my deductible, oop max etc.

[allycatt98 35]

I don't understand why so many people are shocked by the fact they have to pay the surgeon up front or pay their deductible up front. The surgeon usually has an up front fee. I am have had six surgeries and have always had to pay an fee before surgery. Sometimes they would send it back to me, sometimes they wouldn't. I'm just glad I have met my deductible and out of pocket before my wls. Not trying to be rude, but some of you obviously don't understand how insurance works, give them a call they can explain everything to you.

Well being that I am the one that posted it my issue was that 2 months into the process financials still had not been discussed by my surgeon's office advising me what or when I needed to pay not the fact that I had to pay. My insurance company can't tell me what the surgeon or hospital fee is or when they require it only what my policy covers, my deductible, oop max etc.

DonaiA,Your insurance company actually can provide you an estimate of charges just as they provide it to the physician. The estimate will be based on the contracted rate for the surgeon and/or procedure. It's just a matter of giving you the negotiated rate that will be in your EOB up-front. But what they can't tell you is how much the physician will require up-front. I can understand your frustration on this point. I won't be having surgery until July, but I contacted the hospital to get more info about payment expectations. When I told them the surgery hadn't been scheduled yet, they didn't want to talk to me. I've got a $3000 deductible and $6000 MOOP. I can't wait until a week before surgery to find out how much they want to collect up-front. Were you finally able to get the pricing info from the office?

[Get.Waisted 45]

How about my surgery is on Tuesday and the hospital just called and told me that I have to pay my entire $2,000 deductible on Tuesday before surgery. After I freaked out, I told her I don't have it and that's not what I was told. She said, ok pay $250 and we'll bill you for the rest, but you can make a payment arrangement. Nowadays the hospitals are asking for the deductible up front because they've been stiffed too much by people who don't pay theirs. I understand, it's not charity, it's a business, but damn, springing that on people at the last minute is not cool. I know that I'm going to be getting loads of bills from the hospital, the anesthesiologist, the surgeon, etc., but I don't care. Nothing, and I mean NOTHING is going to keep me from my surgery on Tuesday. I'll be paying bills until I die, but with this surgery I'll be paying bills much longer and that's ok with me:)

Do you have an out-of-pocket max? If so did they ask for that at any point. I'm asking b/c my deductible is $500 which I've just about met and I have an o-o-p max of $2300. I'm thinking the hospital may ask me for that also. I know they all are differs just wondering what your experience was. I'm still waiting on my approval and don't want any surprises! Lol

[BetterNai88 54]

DonaiA,Your insurance company actually can provide you an estimate of charges just as they provide it to the physician. The estimate will be based on the contracted rate for the surgeon and/or procedure. It's just a matter of giving you the negotiated rate that will be in your EOB up-front. But what they can't tell you is how much the physician will require up-front. I can understand your frustration on this point. I won't be having surgery until July, but I contacted the hospital to get more info about payment expectations. When I told them the surgery hadn't been scheduled yet, they didn't want to talk to me. I've got a $3000 deductible and $6000 MOOP. I can't wait until a week before surgery to find out how much they want to collect up-front. Were you finally able to get the pricing info from the office?

Yes my coordinator ended up giving me what I'll have to pay and I pay it at my pre-op appointment but I'm hoping by the end of my 6 month supervised diet I will have met my oop max in which I'm about $231.00 away from meeting.

[Jersrose43 837]

I don't understand why so many people are shocked by the fact they have to pay the surgeon up front or pay their deductible up front. The surgeon usually has an up front fee. I am have had six surgeries and have always had to pay an fee before surgery. Sometimes they would send it back to me, sometimes they wouldn't. I'm just glad I have met my deductible and out of pocket before my wls. Not trying to be rude, but some of you obviously don't understand how insurance works, give them a call they can explain everything to you.

I am not ignorant of my insurance. Completely the opposite. You must be lucky and not have a large out of pocket.

I know how much everything costs and what I will pay at every moment. And that is why I will never pay a penny, nickel or dime up front. If I am cash pay then that's different. But with deductibles it's all about who gets the bill in there first. I am not willing to give a hospital or doc several thousand when the anesthesia and radiology will get in first. I will owe them that money.

So I pay when I get an EOB or a bill and never up front.

That happened to me once 5 years ago. I was $4500 away from the deductible so i paid $1000 to the hospital up front with promise to pay $1000 a month after.

Well surprise I got was anesthesia doc charged more than hospital stay was allowed. No joke. The anesthesia charges were $18.000. And the hospital allowed from insurance was $4800.

Anesthesia was out of network so they got paid and wanted my deductible, and guess who got his bill in first? Needless to say hospital got fully paid and took me 90 days to get a refund from them.

Anesthesia took a lot longer to come to an agreement and a formal filing of complaint with the medical board for excessive fees. I paid them nothing. They put it on my credit report I filed another complaint and lawsuit.

[allycatt98 35]

DonaiA,Your insurance company actually can provide you an estimate of charges just as they provide it to the physician. The estimate will be based on the contracted rate for the surgeon and/or procedure. It's just a matter of giving you the negotiated rate that will be in your EOB up-front. But what they can't tell you is how much the physician will require up-front. I can understand your frustration on this point. I won't be having surgery until July, but I contacted the hospital to get more info about payment expectations. When I told them the surgery hadn't been scheduled yet, they didn't want to talk to me. I've got a $3000 deductible and $6000 MOOP. I can't wait until a week before surgery to find out how much they want to collect up-front. Were you finally able to get the pricing info from the office?

Yes my coordinator ended up giving me what I'll have to pay and I pay it at my pre-op appointment but I'm hoping by the end of my 6 month supervised diet I will have met my oop max in which I'm about $231.00 away from meeting.

I'm so jealous!