Out of Network --Insurance Bill

I had surgery on 8/4/03, with an out of network provider (BCBS of SC 70/30 split). My problem is with the bill for my surgeon. The total bill is $6197.00. ($6,000 for the surgery and $197.00) for my initial doctors visit. BCBC paid only 70% of the 197.00. They are telling me that the $197 is the customery service fee. This can not possible be true.....If I understand them correctly, they are telling me that if my surgeon was in network they would only pay $197.00 and the surgeron would right off the other $6,000. How can this be....the doctors would go out of business at this rate..... It looks to me BCBS is trying to get out of paying for my surgery which was preapproved....They have paid for everything else but the surgeons fee. Has anyone else had this problem and how do I go about getting this fixed.

What was the denial for the surgeons fee. It sounds to me that they paid for the pre-op visit, but they had some sort of problem with the fee of the surgery itself. Not that they feel the 197 should be the total billed for both procedures billed, but that they need more info on the surgery fee. Call and ask the ins company. Also your surgeons office is far more experienced with insurance billing than you are, lets hope. They will understand the denial for that particular procedure and most likely resubmit the billing for payment. There is no way any surgeon that was in network would agree to write off the entire surgery billing. Sounds like a billing screw up to me.