billed for 2 surgeons..what the?(Rockwood clinic)

So I went to my health insurance website to check out my bills out of curiosity.  I was shocked to see two different bills for the exact same amount for two different surgeons.  One of course was my surgeon and the other was one of his counterparts in their office.  I called patient accounts and they are telling me that the second doctor was in the room "assisting".  I have talked to a couple other peole that had surgery at Rockwood and they were billed for only the one surgeon.  Plus I never met this other doctor and was not told he would be in there also why would he charge the same amount for "assisting"?   I am not a happy camper right now, I am waiting to hear from one more friend before I call the office and talk to Teresa about this matter.  Have any of you been double billed like this?

THANKS!!
~Kara

Do know if you have a co-pay for the surgeons fee?  My insurance paid it in full... but I realize that is not the same for all insurance companys.

I am not sure if the Rockwood clinic works with Residents in the hospital - my surgeon had 2 surgical residents helping on my case (virginia Mason is a teaching hospital)  If a resident was not available then your surgeon may have had his partner assit with the surgery.  The Assistant surgeon usually can only bill for 20% of the main surgeons fee.  Your insurance should change the allowable you can be responible for and you may have to pay your co-pay for the assistant surgeon's fee.

For example ... if the Main surgeon billed $5000 which was also your insurance company allowable fee (just to make things easier)... the assist surgeon can bill $1000... and lets say you have a 20% co-pay .. then your insurance would pay $4000  - you would pay $1000 for Main surgeon AND your insurance company would pay $800  - you would have to pay $200 for the assistant.

All that said... your insurance company may not allow an assistant surgeon to bill for assisting on this surgery..... so you may not be responsible for the assitant surgeons fee.

I hope this helps.... dealing with insurance billing can be as clear as MUD sometimes...

Helen

 

OoOO my goodness Kara that is unbelievable! I hope they get this worked out. You better not have to pay for any extras.

It's not unusual for a surgeon to have an assisting surgeon with him and the uinsurance should cover it. Your surgeon can't hold all the equipment and cut at the same time, there are almost always assistants.

I guess my problem is that I have talked to 2 other people that had surgery there and they only got one charge.......Weird.

I was only billed for one doc.  Sorry i can't help you.
 Be sure to ask qustions.  Good luck to you     Alice

I called the office today and was told that occassionally a doctor will ask another doctor to assist.  I was also told that the bill that was submitted to the insurance company isnt neccessarily what he will get paid (my insuance will work out a different payment arrangement with them).  They said I probably wont have to pay anything out of pocket for the assistant but if I did get a ridiculous bill that she would put me in touch with someone that could help.  Hope this makes sense?