Over Charged

[Sept2 0]

I had secured coverage approval from my insurance before surgery. The doctor told me that he charges $5,000 and the hospital charges $10,000.

Well my insurance said they cover up to $10,000 on the surgery, so that would leave me with the rest which I was prepared to pay.

Well I check with my insurance company today and they said the the hospital billed them for $27,091.72, and that they are only going to pay $6,413. The doctor billed for $5,000 like he said he would and the insurance only paid $1,840 of that bill. Is this a usual practice by the hospitals and insurance? Does this bill get negotiated down? That amount does not include lab work,anesthesiology, or the other pretest I had to do.

[LISAMARIE1158 0]

Hi Sept...l too had a simular experience..When l got my bill for my surgery, it said l owed $4,000..the hospital charged my insurance company over $23,000 for the procedure..Suddenly when l questioned both the insurance and the hospital, they found a mistake..My insurance, BC/BS actually paid the entire bill never questioning it..well upon checking, the hospital billed my insurance twice for the actual lap band, which they say that small piece of plastic is $9,000...suddenly my bill dropped to 1/2...but bec the lap band is concidered durable medical equipment, my insurance pays 70/30...can you imagine the carelessness of the insurance by just paying the bill in the first place..Was l the only one to ever have this lap band procedure? The insurance thought it was quite funny and then said, l guess you just saved yourself $2,000..No where in my dealings with the insurance company or in my approvals did it say any of this...l was expecting a bill for $100.00....look into the billing, like l did...good luck

[Sept2 0]

Thanks for the reply. I am going to call the hospital tomorrow to see if there was any mistakes. I was told by the surgeon twice that from start to finish it would be around $15,000.