Cost of surgery -- WOW

[2ndTimeFreedom 104]

So I was just wondering why the insurance company called me a few times to ask me the same question a few time today "Do you have any additional insurance?' My answer was no just an employer-provided health insurance policy. So I decided to look at the pending medical claims for my surgery..... nearly 350K!!! I am simply in shock. Has anyone else looked at the cost of their surgery prior to insurance coverage?

[New&Improved 1,780]

That's not normal most I've seen is 20k

[Dr-Patient 830]

That's ridiculous. There is NO WAY any wls costs that much; nor ANY surgery period.

Did you and your doctor discuss cost before you had the surgery? Get the bill to the doctor's office business manager, etc.

Again, that is NOT at all appropriate.

[2ndTimeFreedom 104]

Exactly!!! They are still pending claims-- The surgeon & PA surgical assistant claims are 299k alone. The remaining portion comes from the hospital. I am just astounded and so happy I have a threshold that I am responsible for that is nowhere near that!!!!!! I am also interested in seeing how the insurance will reduce those claims down.

[NYJenn 1,463]

Mine was $19,000...I’ve never heard of anything close to $350k

[Losingit2018 1,170]

Sometimes they bill the insurance company like that knowing that the insurance company is going to cut it down to their allowable costs

[gabybab 696]

Mine billed $104,00.00

I paid $250.00

They never pay what is billed out.

But, 350k seems a little crazy!

Edited July 25, 2019 by gabybab

[Jdymitc 43]

I just had my sleeve on the 15th. The hospital submitted a little more than $19,000. I was in for 2 days. Haven’t seen a claim from the surgeon yet.

[WeeDee 6]

Wow. I’m going in August 29. No idea on cost but I hope it’s closer to the $20,000 area.

[AngieBear 2,524]

Whoa. Mine was 32k, which is kinda high imo. My part of it was much less.

[RickM 1,748]

They often submit all kinds of outrageous numbers to see what sticks and then accept what is paid (particularly if they are under a network contract - then they have no choice but to accept what is paid). But I haven't seen anything that high - 80-100k submitted is not unusual but the normal contracted price is usually somewhere in the 10-20k range, maybe a bit more for a bypass.

As to the insurance company asking if you have other coverage, that is just the company looking for someone else to share the cost with (though usually we see that mostly with orthopedic or injury surgeries where there is the possibility of an injury lawsuit or workers comp claim that they can hang it on, but not usually something like bariatrics that they normally have already pre-approved

[Briswife15 890]

My insurance company was billed roughly $50,000 for the surgeon's fee, anesthesia, and hospital, but they only paid a portion of that.

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[Macy6 356]

Mine was $42,000 before discounts, $12,000 in discounts. I had a 2 night stay. My surgeon and anesthesiologist fees were separate ($5,000 & $3,000 each)

[2019CD 18]

Total rip-off

[Briswife15 890]

Total rip-off

How is it a "rip off"? These surgeries are life-changing procedures. Yeah, they charge the insurance companies a lot of money. But you can't deny the surgeries are worth every penny.


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