Cost of complications

[Cmd6715 0]

I was self pay at a surgical center and had to go to a hospital 10 hours later for another surgery because of internal bleeding(nicked artery), needed several transfusions and spent 3 days in the hospital plus had to have more blood and Iron transfusions after leaving that hospital. I’m now stuck with over $175,000 in hospitals bills and more still coming. BCBS is denying the claim because they don’t cover bariatric surgery or complications. The hospital billed it as complications of lap band instead of complications of gastric sleeve. I’m told it doesn’t matter because they won’t pay either but what if I want to appeal it, shouldn’t it be billed correctly?

[SleeveToBypass2023 2,534]

17 minutes ago, Cmd6715 said:

I was self pay at a surgical center and had to go to a hospital 10 hours later for another surgery because of internal bleeding(nicked artery), needed several transfusions and spent 3 days in the hospital plus had to have more blood and Iron transfusions after leaving that hospital. I’m now stuck with over $175,000 in hospitals bills and more still coming. BCBS is denying the claim because they don’t cover bariatric surgery or complications. The hospital billed it as complications of lap band instead of complications of gastric sleeve. I’m told it doesn’t matter because they won’t pay either but what if I want to appeal it, shouldn’t it be billed correctly?

A couple of things. I have never heard of anyone having a sleeve and not spending 1 night in the hospital. It was done as a same day procedure?

And it should have been done in a hospital. Was it done in a surgery center and not the hospital? If so, why?

When I had my sleeve and later my revision to bypass, BCBS paid for both. Why did they not pay for yours? Typically if you're self pay, insurance won't pay for any care pertaining to that procedure if it was something they already wouldn't cover.

Have you reached out to the surgeon who did your surgery? What did they say about the complications? And I guess I'm confused about how an artery was knicked and nobody noticed for 10 hours.

And yes, if you had a sleeve and it was billed as a lap band, it most definitely needs to be corrected.

[nkta6487 10]

Definitely reach out to the surgeons office bc BCBS tried to pull it saying it wasn’t covered but it actually was I had already checked before going through the program

[Cmd6715 0]

Sleevetobypass2023- Yes they did the sleeve at a surgical center (very common in Florida) they have private staff to keep you over night but at 10:15pm when it was time for me to walk again I was dizzy and my BP was low so they called my husband and told to drive me to the hospital that my surgeon text him the info for. By the time I arrived at the hospital I had already loss 2000cc of blood and looked 9 months pregnant.

As far as the surgeon he said he is sorry, these things happen and there is nothing he can do. He won’t even help have the hospital correct the billing codes.
BCBS told me they don’t cover any WLS or complications from it but they paid to remove my lap and 3 years ago.