BLUE CROSS PROBLEMS!!!

ANYBODY ELSE HAVING PROBLEMS WITH BLUE CROSS ON PAYING THE SURGEON THE ASKING AMOUNT? MY SURGEON'S BILL WAS 12,635 AND THE INSURANCE COMPANY PAID ME 1100.00 SAID THAT'S ALL THEY PAY AND IT'S REDICULAS TO THINK THAT THIS PROCEDURE CAN BE DONE LAPOROSCOPIC FOR 1100.00 IF THAT WAS THE CASE NOBODY WOULD HAVE TO WAIT FOR INSURANCE APPROVAL. NOW THEY SAY I'M RESPONSIBLE FOR 11,453.60 AND I HAVE A NOTE LOAN COMING DUE FROM WHEN I PRE-PAID THE SURGEON $6500.00 UP FRONT I'M VERY DISTRESSED OVER THIS IF ANYBODY CAN GIVE ADVISE I WOULD REALLY APPRECIATE IT. BY THE WAY I'M DOWN 75 POUNDS FOR A BRIGHT SIDE TO ALL THIS

I have BCBS and my understanding is that when they (dtr, hosp, etc)have a contract with the local BCBS they agree to the insurances terms. BCBS has a certain amount they pay on each procedure...and the medical office is aware of these amounts. BCBS will not pay over those amounts and the medical office HAS to accept what the insurance will pay. (your dtr may not have a contract with them) You are not responsible for whatever the medical costs they charge that are over that amount. It is all part of their contract. My surgeons bill for open RNY was over 9,000 but since my doc had a contract with BCBS the insurance paid 2400.00...they have to settle for the amount paid per their contract. I don't know if this applies to you...but that is how it is for us. Donna