I've been a bit quiet lately...

What would the difference have been had you used an in-network doctor for your surgery?  Don't worry about what you can't control.  Send them a payment of $25.00 a month ... these insurance companies are not hurting ... no where near like we are!

OUCH that sounds painful.  Although you went to an in network doctor, did anyone submit for pre-approval?  If so I'd definitely be going back and fighting the insurance company more.  If not, I'd be questioning the doctor as to why they didn't get pre-approval (it's pretty normal) and insist they work with you on the price and payment plan.

Good luck!!!

In network they Dr. would have had to take what the insurance paid him regardless of the amount he billed.  I freaked on the lady and told her no damn Dr's were in network anymore because you don't pay them $#!T!!! 

The surgery was submitted and pre-approved.  The insurance pays out of network Dr. 80% of what they deem is "usually and customary" for the service.  Hell you can't even get  a route canal and a crown for 1200 bucks let alone a full on surgery WTF! 

The hospital was paid as an in network provider and they were paid HALF of what they submitted but cannot bill me for anything further as a particpating provider.  The Dr. however as a non-particpating provider can recoup ALL of his costs if he so wishes.  He is not, they are writing off anything above 9K and I was told today they will try to reduce it even further as I've already paid them a significant amount.

So regardless of insurance and pre-approval for surgery I'm still out...it could have been worse had they not paid the hospital bill but I made sure the hospital was listed on their website and the dr's office also got that approved with the surgery as the facility before I even stepped foot in there - otherwise my bills would have been 50K...LORD!  I need a nap! 

OMG Nikki, I am sorry to hear about all this crap. I think you should pay them $5.00 a month. They can't tell you what you can afford to pay. I had the same problem occur when my hubby had a stent put in. We got a $33,000 bill from Wash. hosptial center and then had to pay 3 grand. I told them I will pay them $25.00 a month. They  billed BC&BS for outpatient instead of inpatient. I have been fighting them and trying to get it re billed but am told that it is the doctors fault since he did not write to admit him on the chart. This is a joke. I am stuck !

                                                                                                            Julie

im not a pro at this, but when i did my research, i checked to make sure the ins covered. in maryland, if there are certain number of employees in a  company, they have to cover according to law. i think you should appeal that all the way to the insurance commission. i hope in the end you dont have to pay that bill.


i hope everything works out.

brian