Beware...COVA/Anthemn Covered Surgery, But Not Anesthesia Doc

I had lapband surgery last month at St. Mary's Hospital in Richmond. My insurance covered my surgeon, but not the anesthesia doc. Somehow, stupid me, assumed that he would be covered, but he was not in my insurance provider's network. I was socked with a $1,188.00 bill. Do you guys think that I could negotiate a lower rate with his office? If so, what would be a good ballpark figure to negotiate? Any feedback would be appreciated. Thanks! Evelyn C...

WOW - Evelyn, that's terrible!!! Um, I'm NO insurance expert, won't even pretend otherwise, but is your insurance company refusing the ENTIRE anesthesia BILL?? I mean, c'mon - so the doc is NOT in your network, fine, don't pay a 100% - but I always thought that if you went OUT of network, they'd at least pick up a portion, you were just responsible for a co-pay. Have you talked ot the insurance company about it? I know, its probably a dumb question on my part, but thought Id ask, just the same. Ive had my insurance company (TriCarePrime) tell me "No" ...or "Can't do that" the entire WEIGHT LOSS and PLASTIC SURGERY journey - along the way. EVERY SINGLE TIME THEY SAID NO, I argued with them, and every single time, I won. Not saying that's the norm, or to be expected, but I do know that if I had settled for their "generic refusal/no" responses, I would not have outsourced my RNY and my plastic surgeries. b**** the beginning of both of those chapters in my life, TriCarePrime told me I could NOT see a civilian doc (my hubby's navy, that's a military provider) ....by the time I finished ARGUING my point/rights, I was able to get a civilian doc for my RNY and my Tummy Tuck/Breast Lift. ALSO - if you find that all the arguing in the world won't help your case, with this thousand dollar bill? Then I'd get the Anesthesia Doc on the phone (or his staff, obviously) and start negotiating at least a 50% REDUCTION!!! Typical insurance payments to hospitals and docs rarely (if ever) go over 50% billed. Good luck to you - Lei Pssst... one more thing, then I'll shaddap - if it were ME? I'd be agreeing (arguing) for a 70% REDUCTION on that bill. The odds of getting it are slim to none, but at least you have room to negotiate UP - and still feel like you've come out ahead.

Hi Evelyn, The SAME thing happened to me at Fair Oaks. See, when the hospital starts setting things up, they are SUPPOSED to assign an anesthesiologist to your case who is in your insurance network. That's the HOSPITAL'S screw up - not yours. We don't pick our anesthesiologists, so there is no way you should accept any of that blame. So you should do what I did - call your insurance company, and ask them to re-submit. I had CareFist at the time, and the adjustor I spoke to was understanding when I protested the bill. What they wound up doing was approving the charge, and sending ME the check to cover the bill. And yeah, mine was $1200 as well. I got every penny of it. Don't accept no for an answer, either. This is not your debt! Good luck, Kathie