Hellloo medical giant bill~!!!

-Amanda-
on 8/3/12 12:32 pm
I did pay my out of pocket yearly max of 5,000 that was ate up by all the testing before surgery, i also paid what was left for my surgeons fee's before surgery, i thought i was good.
Im gonna try and fight it because i simply have no choice, i could have bought a house. well not a nice one, but.
sevencats
on 8/3/12 12:45 pm
Along with a copy of your insurance policy, I would make sure that you have a copy of the "explanation of benefits" from the insurance company.That should tell you several very specific things:1) what the hospital billed your insurance; 2) what the "agreed upon" amount is; 3) what the insurance paid; and 4)what your copay, if any, can be. You didn't mention how long ago your surgery was, but sometimes the hospital bills on a regular schedule, and your insurance may not have finished paying. SOme time ago, my father had emergency surgery, and I remember the billing lady at the hospital telling my mom: "You're going to get a bill, and your tendency is going to be to pay it. But don't." She then went on to explain that they bill before they've gotten all the insurance payments in, so, for a big surgery, it may take several months before it's all figured out.
So take a few more deep breaths. Gather info, but try not to let the stress get to you. Thinking good thoughts for you. J
k9ophile
on 8/3/12 12:55 pm
On August 3, 2012 at 7:45 PM Pacific Time, sevencats wrote:
Along with a copy of your insurance policy, I would make sure that you have a copy of the "explanation of benefits" from the insurance company.That should tell you several very specific things:1) what the hospital billed your insurance; 2) what the "agreed upon" amount is; 3) what the insurance paid; and 4)what your copay, if any, can be. You didn't mention how long ago your surgery was, but sometimes the hospital bills on a regular schedule, and your insurance may not have finished paying. SOme time ago, my father had emergency surgery, and I remember the billing lady at the hospital telling my mom: "You're going to get a bill, and your tendency is going to be to pay it. But don't." She then went on to explain that they bill before they've gotten all the insurance payments in, so, for a big surgery, it may take several months before it's all figured out.
So take a few more deep breaths. Gather info, but try not to let the stress get to you. Thinking good thoughts for you. J
Excellent advice.  Wait for that EOB statement then ask more questions if necessary.  A friend was getting billed for a massive mistake made by the hospital then they tried to get her to pay for THEIR mistake.  Her insurance actually helped her get it straightened out and she was very satisfied with the outcome.   The hospital had to pay her back some of her co-pay. This is one case where I even had to applaud a usually evil insurance company.

"Our ultimate freedom is the right and power to decide how anybody or anything outside ourselves will affect us."  Stephen Covey

Don't litter!  Spay or neuter your pet

Virgo64
on 8/3/12 4:46 pm
Amanda,

If the max out of pocket you can pay per policy year is 5k and you have paid that amount out already, I don't know how the hospital can be billing you for the rest.  Insurance companies and hospitals contractually agree to what the usual and customary charges are that will be paid, so I don't see how you are going to end up paying a huge bill. 

I tend to agree with one of the other posters who said that it may be that the insurance company hasn't finished paying out yet.  It stands to reason that it will take some time for all of the payments to be made, and everytime they pay the hospital, that 38k will be decreasing.

Please keep us posted... I am pre-op and of course even though I've read my insurance info a thousand times and even have it printed out and in a binder, this still frightens me.

Hang in there
-Amanda-
on 8/3/12 10:55 pm
Yesterday I call both the insurance company and the hospital , what i was told was that the Hospital is an out of network hospital so they have no agreed price. How ever the insurance company doesnt have a Dr. in their network that performs the DS. ugh.
Again i told the hospital I called and wanted to get the amounts and a payment plan before surgery and was told not to worry that they except what ever the insurance pays but they said the only thing they can do is put the collections on hold for 30 days till I figure out what to do.
So nice of them.
Whit
on 8/4/12 9:00 am
Revision on 12/10/12
That's a big bummer. I would think it would be something the Dr's staff would verify prior to surgery when they submit for approvals. I know I have to have Surgery at a COE Center of Excellence.
God Luck.
Whit 

Revision from RNY to DS 12/10/12 Dr. Ara Kesishian BMI: 19

Created by MyFitnessPal - Nutrition Facts For Foods

 

 

 

          

Netti101
on 8/5/12 6:44 am - Norcross, GA
Let them right it off at the end of the year. Say they will get it when you have it. What are the going to do Repo your surgery.
k9ophile
on 8/6/12 5:48 am
On August 5, 2012 at 1:44 PM Pacific Time, Netti101 wrote:
Let them right it off at the end of the year. Say they will get it when you have it. What are the going to do Repo your surgery.
Hospitals do turn people over to collection agencies.  I had a bill for about $35.  One week after I got the bill, I got a call from a collection agency.  What pissed me off is that I worked for the hospital that billed me. 

As Southern Lady said, do not pay anything (or panic****il you have all your EOBs.  You can work out a payment plan.  They are a business so they won't accept whatever you can send them whenever you feel like it.

Hospitals are very notorious for billing errors.  Your insurance company may be able to help.

"Our ultimate freedom is the right and power to decide how anybody or anything outside ourselves will affect us."  Stephen Covey

Don't litter!  Spay or neuter your pet

-Amanda-
on 8/5/12 2:06 pm
 I just feel so bad that I let myself get in such bad physical shape 
That I needed surgery to help myself then turn around and cause terrible grief to my family
For  a huge bill., hey don't deserve what ive done to them.  :(
sevencats
on 8/5/12 3:48 pm
Amanda, I understand that you're feeling really badly about this--any of us would be upset--but please don't beat yourself up so badly.  I am sure that, even with the expense, your family are happy to have you around alot longer than could be expected if you remained obese.   And, even if you looked at it purely financially, you will probably be able to earn that sum many times over simply by becoming healthier and having a longer work life.  That money is an investment in your future, and in your family's future.  It's a good thing that you've made the choice to take care of yourself.

While I think you're worth the investment...I still want you to take a good look at what your insurance policy says your benefits are.  I am guessing, given the figures that you gave us earlier, you'll find that it says that your co-pay is 40% for an out of network provider.  It should also list the out of pocket max both for in network and out of network.  While the max for out of network is probably higher--in my policy, it's double the in network--I bet there still is one. 

Check into that; also keep checking in with us.   While I expect that you'll end up paying more than the $0 you originally expected, I doubt that you'll have to pay that whole amount.

And remember to keep breathing.  It's important that you take good care of yourself, and don't let the stress get to you.  J
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