Has anyone had this happen

CarlaG · April 25, 2008

I am self pay and I just received a bill for $3500.00 for hernia repair during my lapband surgery.

First I'm a little upset that the "whole" band fee for the surgeon was $5500 and now I have a bill for an additional $3,500 for "a couple of stitches" as the surgeon put it!:rolleyes2:

My question is this...my insurance would have covered a hernia repair if I had the proper referrals. Has anyone ever gone back after the fact and gotten a hernia repair covered?

I just don't know what I will do if I have to pay another $3,500. I already got a loan to pay for the lapband. :cry_smile:

I'm feeling extremely quilty right now about this whole thing :confused:

Acactusflower · April 25, 2008

Were you aware of the hernia prior to surgery? Make sure the hernia repair is not a result of a misguided Lap Band procedure as in my husband's case which resulted in a 2-week delay in having the band placed and a second surgical procedure because he had to wait for the hole in his stomach to heal. Our insurance required a second authorization for the second surgery.

During my procedure, there was also a "hernia" repair involved that was not covered by the insurance because it was not an approved procedure.

CarlaG · April 25, 2008

It was not known before the surgery "officially" but I was having some problems swallowing that I had already told my primary care doctor about so I wasn't surprised.

I did call my PCP and they said the surgeon should file a claim and go from there but because I have an HMO I'm a little worried about it.

I guess all they can do is try.