Why Do We Owe $2000 MORE than was quoted?

[aprildurham23 0]

My husband and I got the band in Dec. and just got word from our insurance that instead of the $1500 per person, we are going to be charged $2500 per person....for literally NO GOOD REASON!! They told us that it would be about $3000 total for both my husband and I to get it after our insurance covered the rest. Now we are being charged $5000. This is NUTS. Did this happen with anyone else? The surgeries went well without a hitch, and neither of us have ANY problems at all (in fact it's like the band isn't even there, which is unfortunate...going in for another fill. ) But not only that - I had to sleep on a gurney!!! Yeah, they didn't have a bed for me to sleep on so they gave me a gurney! Ridiculous! We are def. gonna fight this, I am just wondering if you have any advice??

Edited February 3, 2009 by aprildurham23

[Cleo's Mom 257]

Do you have anything in writing where they said the amount you owed would be $3000? You say "about $3000" which to them could mean $5000. Every health insurance plan has some type of complaint system if you don't agree with a bill. Use it. Plus the hospital should have some type of patient advocate. Call and find out and use them. Need need other resources on your side. Good luck.

[aprildurham23 0]

Do you have anything in writing where they said the amount you owed would be $3000? You say "about $3000" which to them could mean $5000. Every health insurance plan has some type of complaint system if you don't agree with a bill. Use it. Plus the hospital should have some type of patient advocate. Call and find out and use them. Need need other resources on your side. Good luck.

Yes, actually. They gave us this form on surgery day that we filled out with credit card info etc... Actually THEY filled out the "estimate" part, and it said that amount. But again, it was an estimate. So I dunno.

[chicamam1 1]

Yes, actually. They gave us this form on surgery day that we filled out with credit card info etc... Actually THEY filled out the "estimate" part, and it said that amount. But again, it was an estimate. So I dunno.

did the ins give you this form or the doctor? if its an estimate its not a guarantee of payment, which means any benefits quoted can be subject to many different factors or based on how the provider is billing for the service. Your best bet to figure out why the estimate went up, is to call the insurance company and speak to them directly. Unless you have a guarantee in payment in writing, nothing you can do because typically you wont know how the ins will pay out until the claim processes otherwise. GL

[twiggysmiff 0]

My husband and I got the band in Dec. and just got word from our insurance that instead of the $1500 per person, we are going to be charged $2500 per person....for literally NO GOOD REASON!! They told us that it would be about $3000 total for both my husband and I to get it after our insurance covered the rest. Now we are being charged $5000. This is NUTS. Did this happen with anyone else? The surgeries went well without a hitch, and neither of us have ANY problems at all (in fact it's like the band isn't even there, which is unfortunate...going in for another fill. ) But not only that - I had to sleep on a gurney!!! Yeah, they didn't have a bed for me to sleep on so they gave me a gurney! Ridiculous! We are def. gonna fight this, I am just wondering if you have any advice??

My insurance company always says that any benefits or estimates that are told to us prior to a procedure is just an estimate and the final amount could change depending on the claim itself. It could be that the doctor's fees/hospital fee/anesthesiologist fee could be greater than what the insurance uses to determine cost prior to the procedure. Good luck fighting it, but I doubt it will change the cost. Insurances are good at paying the least amount that they can!!!