Insurance claim

[liveaboard15 1,293]

So i had my surgery 4 weeks ago and i am self pay. I paid about $18K... Today i checked my insurance and looks like the hospital made a claim for the surgery... My responsibility amount... $40,000. when i saw that i was like WTF is this claim? Oh i am going to be making phone calls tomorrow... lmao. WTF. They trying to double dip. haha.

[Sunshine Princess 203]

Hospitals will bill insurance as a first line of coverage. They often don’t know the arrangement you’ve made directly with the surgeon. I’d give your surgeon’s office a call and also call the billing dept in the hospital to let them know you have an arrangement elsewhere .

[liveaboard15 1,293]

2 minutes ago, Sunshine Princess said:

Hospitals will bill insurance as a first line of coverage. They often don’t know the arrangement you’ve made directly with the surgeon. I’d give your surgeon’s office a call and also call the billing dept in the hospital to let them know you have an arrangement elsewhere .

the funny part is i could not even schedule the surgery until i called the hospital to pay. The surgeons office fee i paid there during my appointment. For a second i thought my insurance would pay it and i would get back my $18 grand lmao. But nope i can see in the claim already that they denied it and that i am responsible for the $40K LOL But i sure will be calling tomorrow several places.

[Kay_G_B 10]

I was told by the hospital & my insurance that my procedure would be covered, then I received a bill for $32k. I was back & forth with the hospital several times prior to my surgery when my original responsibility was $12k. Then after my surgery the price doubled. Nobody could explain to me why & I got hung up on every time I asked. When I look at the breakdown, I could see that the hospital billed my insurance for $151k, which is like 5x the amount of the surgery. But once again, nobody from the hospital can explain to me why.

[catwoman7 11,210]

they usually charge insurance companies way more than they charge self-pays. Happened to me when I had plastic surgery. Once the insurance company denies it, you'll get the bill, and it should be whatever you agreed to pay the surgeon.

[kcuster83 1,504]

10 hours ago, Kay_G_B said:

I was told by the hospital & my insurance that my procedure would be covered, then I received a bill for $32k. I was back & forth with the hospital several times prior to my surgery when my original responsibility was $12k. Then after my surgery the price doubled. Nobody could explain to me why & I got hung up on every time I asked. When I look at the breakdown, I could see that the hospital billed my insurance for $151k, which is like 5x the amount of the surgery. But once again, nobody from the hospital can explain to me why.

Oh man, I would flip! I actually made sure I had a letter of approval from my insurance in my hands. I still ended up with $6400 out of pocket though. Insurance sucks!

[liveaboard15 1,293]

So i called the hospital this morning and the person was like "Yes you had surgery and you used your insurance" i was like BULL SHIZZ... i am self pay and i had to pay before i could even schedule my surgery. so now they gotta investigate and said they will let me know in 20 days... wtf

[kcuster83 1,504]

13 minutes ago, liveaboard15 said:

So i called the hospital this morning and the person was like "Yes you had surgery and you used your insurance" i was like BULL SHIZZ... i am self pay and i had to pay before i could even schedule my surgery. so now they gotta investigate and said they will let me know in 20 days... wtf

They are so quick to tell you that you owe money but boy when it comes to them not getting money it takes FOREVER!

I hope you have receipts.

[Queen ApisM 427]

Oh this happened to me. I was self pay, and then they were charging me for some sort of pathology which should have been included, I tried to get that taken care of, and then I received a bill for $32,000. 🤨 The billing department was useless and made it worse, so I went straight to my surgeon's office and they put the kibosh on it way faster than I could. I'd reach out to your surgeon's office, esp if there is someone there you dealt with for payment and logistics, and see if they can help.

[liveaboard15 1,293]

3 hours ago, kcuster83 said:

They are so quick to tell you that you owe money but boy when it comes to them not getting money it takes FOREVER!

I hope you have receipts.

Yup i sure do have all my receipts. and i paid with my debit card so those transactions are there

[kcuster83 1,504]

3 minutes ago, liveaboard15 said:

Yup i sure do have all my receipts. and i paid with my debit card so those transactions are there

Great! Always good to keep your bum covered! It is sad how many people learn that the hard way.