$80,000 for a hiatal hernia repair?!? And I am self- pay!

I just received an explanation of benefits from Aetna telling me that I will owe an additional $24,023 towards the bill they received from my surgery center (which IS a COE) for $80,000 for a hiatal hernia repair that was done while I was having my VSG.  I have no bariatric surgery coverage so I was completely self - pay for the VSG to the tune of $16,150 and when my surgeon told me he would be repairing the hernia, which was found pre -op, neither he nor the financial coordinator mentioned additional charges or billings.  

Now, I am happy that I had insurance that would cover sme of the cost of my surgery but they were paid a total of over $60,000 for a surgery that my friend who has no insurance paid $16,150 for with the same added hernia repair done.  It seems to me that this is in some way fraudulent or at the very least morally questionable.  My understanding of what it takes to repair a hernia while in the process of doing the VSG is possibly and additional incision and a couple of stitches.  How on earth does that add up to the $44,234 that my insurance paid them?  And then they also get the $16K from me???

i could absolutely use some perspective here, as I am feeling slightly used and abused by the people that I wanted to trust with the most life changing choice of my life.

Oh, and insult on top of injury, they sent me a $354 bill for an appointment I was told was covered by the $16,150 I already paid them.

Any one else have a combination of being self pay and have your insurance billed?

UHM, this seems like a typo or something to me.  Maybe it was supposed to be $8,000 and the doctors office messed up the coding?  I had a hiatel hernia repair at the time of my VSG too and I remember I got the statement for it and it was NO WHERE near $80,000!!! Something is WRONG...investigate it!!! seriously!  Btw, I was not self pay, total insurance coverage but this STILL seems crazy to me. 

Yeah, believe it or not, it isn't a typo they actually submitted one claim for $40,000 and two others for $20,00 each.  There isn't any detail on amyof it so I have requested all of my records, including the OR report and the detailed idling to the insurance.  It is interesting that I left a message for the person who handles all their billings, I got bumped up to the office manager, and have heard back from no one. Hmmmmm, it would seem to me if this is a straight forward situation it could be easily explained in one phone call within one business day and it has been three days. WTH!!

My hospital bill for my VSG surgery which was complicated and over 4 hours because of damage left behind from removed band was just over $81,000.  That was just hospital and included two nights stay. Anesthesia was $2500 still waiting on surgeons fees

No hernia repair that was done 2.5 years ago when I had band but I know the hospital bill at that time wasn't that much

 

I was only in surgery for the planned  one hour, maybe a little less, and I went home that day so no hospital stay either.

Damn....I know my surgeon in Mexico would INCLUDE a hernia repair if they found it at time of surgery...I have one now, and my insurance is meh. My surgeon would charge $4000 to repair it...

Yes when I look at the difference between what was paid by my friend at the same surgery center for the same exact surgery which was $16K and they were paid $$60,000 for mine something is NOT right with this!

Wow....I also had a surprise hiatal hernia repair during the VSG. Not a cent more was charged by anyone...I paid and my insurance reimbursed me 14,000 $. My surgeon said the repair extended surgery time by 15 minutes, a few stitches and one more incision. He didn't even mention any hint of an extra charge. Wow! I am really shocked by your situation and I hope you sort it out. Tnis sortof thing should be very clearbefore surgery in the event of... Etc. good luck! Hope its some sort of a mistake.

Thanks Julia! I really was starting to think I was losing my mind and that this was just SOP for this situation.  I will keep on digging until I get it sorted out.

I was self-pay and had a hernia repair also. My health insurance deductible was already met for the year at the time, so I didn't come out of pocket any more than the cost of surgery. The surgeon billed $3500 for the hernia repair and was paid $968 through the insurance after their discount. The assistant surgeon was billed $1750 and was paid $293 from insurance. Clearly something is wrong here, and I also think there was some sort of clerical error. Call your insurance company as well as the surgeon's office to get things figured out. Good luck!