ANGRY!

I am FURIOUS with the surgeon & his office that I chose to use for my wls. 

Long story short, the office lied to me and my family that the surgeon was in network. They told me he was and I had my endoscopy done. Today, I received an email telling me that since the doctor ISN'T in network, I have to pay a $2,300 base fee to the surgeon, PLUS all of the out of network costs that each of my pre-op testing will require. 

This is about $20,000+ for me with out of network.

It's so confusing to me, so if I'm not making since to any of you, forgive me. 

But in the end, I'm having to GO TO ANOTHER SURGEON and start the process all over again because I cannot afford the lying surgeon and his office.

At my initial appointment and the next time I saw them, they never once mentioned that the doctor was out of network. At first they told me he WAS in network. I found out he ISN'T associated with any insurance companies BY EMAIL.

I am RED-HOT-MAD.

I can't believe I have to start this whole thing over again. PLUS, I have to pay for the endoscopy OUT OF NETWORK when I had it done with the understanding that he WAS in network.

This whole ordeal has made my excitement, hope, and motivation for a healthier life just disappear. I'm pretty devastated. I liked the doctor and his staff until I found out this morning that they had lied. Sorry. I had to rant. I'm so confused with this office and how rude the women on the phone were. 

I need to know I'm going to be able to receive my surgery but all of these people are confusing and only out for the money. 

ugh!  sorry this happened to you.  Maybe they can provide something that shows they are in the process of being In network, so that you can dispute the charges...

Thanks for the reply. Sadly, they aren't going to be in the process of being in network. The surgeon doesn't want to be associated with any insurance companies. I'm so bummed. Wish I could just meet a good surgeon and get the surgery. I'm so ready to be healthy. 

I'm sorry this happened.  Does your insurance company have a website?  Are you able to look up which doctors are associated with your network on that website?  This is what I do - I have Aetna.  I don't have to trust the doctor, I can do the research myself.

Good luck to you!

Yes, they do. I had looked up this doctor and the website mentioned the doctor's name as covered but apparently it was a different doctor with the same name? I don't know. Now I don't see his name on the website. 

What I did when I decided to have the surgery is looked up bariatric surgeons in my area. When I found this doctor, I checked on my insurance website to see if he was covered. I thought it said he was covered. Now, after all this, I go to double check the website, and don't see his name.

Like I said, I'm so confused. For one, all of the people on the phone with the surgeons office had no answers to any of the questions I was asking. They kept transferring me to each other. It was "I don't know" and "Let me transfer you to 'so-and-so".

I'm done with them. 

I am PRAYING that this other surgeon I am looking into is good and all of this goes much smoother than the last attempt.

Grr..

may i ask if you have an HMO or PPO plan? doctors these days wont even make an appt unless they have an authorization on file, and when you went to your appointment and handed your card didnt they know off hand that they dont contract with any insurance? 

PPO.

We handed the insurance card right to them when they asked.

They never mentioned anything about being out of network and we were handed the card back a bit later.

It sounds like maybe at the time you first started working with this surgeon that they WERE in your network ..... And have since changed.

Since they showed on your insurance site, it is possible that they did not knowingly lie to you.

They may have dropped off your network, or were removed for some reason ...... It is worth a call to your insurance company to get it figured out.

Unfortunately, unless you choose to be self pay, this type of thing can happen.

I hope you are able to continue your journey.

I'm very sorry that this happened to you.  Health insurance can be very confusing.

It might be worth a phone call to your insurance carrier before you show up at an appointment with a new surgeon to verify that he/she is within your network.  I recommend that you write down the names of anyone you speak to from your insurance carrier just in case you have a glitch in the future.

Unfortunately, we have to be the best advocates for our own health care and do the research to make sure that we're covered.  It takes some time and effort, but will save us major headaches down the road.  

I hope you find someone soon.  Very best of luck to you.