It Literally Pays to Know Your Insurance

[Sharon1964 2,530]

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.

The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.

The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.

I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??

The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.

I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

[ProudGrammy 8,322]

insurance paid $1,600.00 - my portion to... ZERO!

@@Sharon1964

take a bow bud

you questioned the insurance company

moved ahead with your phone calls

discussions about the procedures

talking to a rep

waited for a written response........

mail finally arrived.....

you didn't owe a penny!!!

how great is that - and you too!!

I always hand the phone to hubby

he doesn't mind dealing with the ins co

while i deal with my frustrations

hubby is willing to put up with the insurance company

and with me too!!!!

hubby is VERY smart

he married me didn't he!!

congrats on starting your new healthier, happier, longer life

who deserves it more

good luck with surgery

kathy

Edited March 13, 2015 by proudgrammy

[mykdzmom 387]

I am glad you questioned them. I have more time than money myself, and it never hurts to ask. Way to go!