Received A Bill Finally

[Walter.Sobchak 978]

I am not going to put my surgeons office on blast just yet as I am waiting to see how they handle this, but I am very upset. When my wife and I first started this WLS journey we met with the finance department and went over all the costs and what our insurance would cover and what not. We were told at most we would each owe 3500.00 once it was all said and done. I had my surgery over 13 months ago and not once received a statement. I had been wondering what the deal was, no statements and no phone calls. Then this past week I get a statement showing that I owe for my surgery alone $9500.00
I was so pissed. I called the office and of course couldn’t get a hold of the lady I need to speak with. I called 4 times before she finally called me back. She told me that what I owe is accurate. I told her that is not what I was told when the journey started. She said she would look into it and call me back. She would also send me some additional documents to fill out. I am so mad and feel like I was deceived. I would have paid less going to Mexico. My anger has since turned to sadness and depression.

[insta_adventurer 1,046]

I would be furious, too! Did they give you an estimate to sign?

Also- if it were going to be that costly- I’m surprised they didn’t demand payment up front prior to surgery. My hospital required me to pay my co-pay at pre-op testing.

It sounds extremely dubious that they wouldn’t bill or tell you the full amount until after the deed was done. I would fight it tooth and nail.

[The Preacher 161]

Unless you have an estimate or something in writing you're probably stuck with the bill.

It's sad to say, but nowadays some people's word is not good enough, so always get it in writing.

I hope and pray that it can be worked out for you.

Sent from my SM-J727VPP using BariatricPal mobile app

[mmartinez213 3]

I am sorry to hear that, I understand it happened to me just in a lower amount. It's gas a lot to do with insurance what they pick up, if you meet your deductible, and anesthesia is part if the bull as well. Dobtvget upset you were misled and it was wrong. You can't change what's done, but you fan make payments forces long as you need and look at the bright side your becoming a new you with the surgery heads up everything has a solution. Never regret helping yourself due to the cost being higher no amount of money can be put on a life feeling and getting better 😊

[Ed_NW 684]

Insurance companies are doing some crazy things in light of the repealing of the individual mandate. Young healthy working class people that don't have employer paid health insurance are taking their chances and not paying the higher premiums. Insurance companies end up with what they consider a sicker pool of clients. In order to recoup some of their losses, (besides raising premiums next year) they will refuse to pay portions of a bill. The healthcare provider will then seek to collect from you the patient. Tell the hospital (or whoever) to resubmit the bill to the insurance. They go back and forth like this all the time. What you don't want to do is just wait and see what happens. At that point they send it to collections.

[Frustr8 7,886]

Not right actions on their part, punishing the innocent in the equation.😦

[Walter.Sobchak 978]

I spoke with the lady and told her this was not what we agreed to. There are two women that handle financing at this office. The one my wife and I met with told us what our portion would be and the other one is the one that sent me this statement. I can’t seem to get the one that originally spoke with is back in January of 2017 on the phone. I am thinking I might have to call and see if I can schedule an appointment just to see her. It’s absurd.

[Snapple 42]

13 hours ago, Ed_NW said:

Insurance companies are doing some crazy things in light of the repealing of the individual mandate. Young healthy working class people that don't have employer paid health insurance are taking their chances and not paying the higher premiums. Insurance companies end up with what they consider a sicker pool of clients. In order to recoup some of their losses, (besides raising premiums next year) they will refuse to pay portions of a bill. The healthcare provider will then seek to collect from you the patient. Tell the hospital (or whoever) to resubmit the bill to the insurance. They go back and forth like this all the time. What you don't want to do is just wait and see what happens. At that point they send it to collections.

Or there are working class people who don't have employer paid health insurance who are being taken advantage of (legally) thanks to Obamacare. My health insurance is $3000/month with a $12,500 deductible per person and it's basically un-useable as it covers next to nothing unless of course I want birth control or to have a baby at age 53. And it sure as hell didn't cover bariatric surgery either.

[Frustr8 7,886]

Isn't it curious that I was told when Obamacare had to pick up maternity care and benefits, Bariatrics was "grandfathered in". Now you tell me I am in error? Dang for $3000 you ought to receive all kinds of lovely benefits. For that amount you should have a licensed face- dauber to wipe your fevered brow.
Dang, 1st time I ever remember Medicare being better,than other insurances. They covered me at 3 months short of 73, without a burp or belch. I always have Medicaid as a back-up, if things don't meet Medicare's hopes. And although I regret not doing this sooner, it's still going to be all good., in the Big Picture.

[Ed_NW 684]

6 minutes ago, Snapple said:

Or there are working class people who don't have employer paid health insurance who are being taken advantage of (legally) thanks to Obamacare. My health insurance is $3000/month with a $12,500 deductible per person and it's basically un-useable as it covers next to nothing unless of course I want birth control or to have a baby at age 53. And it sure as hell didn't cover bariatric surgery either.

I'm 51 years old and work and pay the ridiculous insurance costs myself. It's not going to get better anytime soon. Insurance companies are estimating huge premium increases again in 2019.

[Walter.Sobchak 978]

It’s big business. Someone is getting rich in the insurance and medical field and it sure as shit isn’t me.

[BrookeR 25]

bypass the dr's office and go to your insurance company. I received a bill from the hospital for $12800 and it is because they filed it as my surgeon, anesthesiologist and hospital as all being out of network! I had to literally call them weekly to make sure they were staying on top of it and getting everything refiled and in the end they sent ME a check for over payment of approximately $98. I researched the surgery for 2.5 years before doing it and knew exactly what I would be responsible for out of pocket and kept ALL receipts and correspondence information between myself, the hospital, dr's office and insurance company. The dr's office doesn't care whose oversight it is as long as they get paid. Contacting your insurance company and making sure they filed everything correctly is worth a shot. Good luck!

[kygirl68 58]

I work in medical billing and deal with insurance companies ALL DAY LONG! First off, if you didn't get this agreement with the doctor's office in writing, then you are S.O.L. in that regard. Secondly, it can take a year or longer for medical offices to finally get payment from insurance companies. It is an extremely frustrating process. Insurance companies will repeatedly come up with one reason after another to not pay and drag it out EVEN WHEN THE PROCEDURE IS PRECERTIFIED BY THEM! That being said, you should've been following up with your insurance company all along and looking over your EOBs to see what was getting paid etc. I definitely recommend starting there.

[Snapple 42]

On 10/6/2018 at 11:10 PM, Frustr8 said:

Isn't it curious that I was told when Obamacare had to pick up maternity care and benefits, Bariatrics was "grandfathered in". Now you tell me I am in error? Dang for $3000 you ought to receive all kinds of lovely benefits. For that amount you should have a licensed face- dauber to wipe your fevered brow.
Dang, 1st time I ever remember Medicare being better,than other insurances. They covered me at 3 months short of 73, without a burp or belch. I always have Medicaid as a back-up, if things don't meet Medicare's hopes. And although I regret not doing this sooner, it's still going to be all good., in the Big Picture.

Yes, I ought to receive a lot of things for $3000/month. But I should also mention that my insurance is also an EPO meaning I HAVE to see the in network doctors and hospital (notice that's not plural) for them to pay for it. Too bad none of their doctors or the hospital is within 2 hours of my home!!!!

[Walter.Sobchak 978]

Looking back on it, I should have gone to an in network doctor. It would have made all of this much easier to handle. Instead I was tricked by being told that even though the doctor was out of network everything would be handled as if it were in network.