Question:
How much did you pay the anesthesiologist on self pay?
Mine billed me $3600. The insurance paid $1200, and now they want me to pay the other $1400. My surgeon said that was ridiculus, they should accept the insurance payment as paid in full. How much did you self payers have to pay? — Gail O. (posted on September 19, 2003)
September 19, 2003
I paid $2,140
— e T.
September 19, 2003
Mine billed me $1700. They're getting 10 bucks a month because they didn't
tell me this was supposed to be paid for BEFORE the surgery.
— cinthygrady
September 19, 2003
oops, the insurance has already paid $2,200
— Gail O.
September 19, 2003
I paid $1200. (INsurance covered) but the bill was for $1700.
— Deborah M.
September 19, 2003
I was a self pay. The amount had to be paid up front before the surgery.
The anesthesiologist portion was $1,200 for a lap rny.
— Kelly R.
September 19, 2003
My anesthesiologist fees were $850. I live in Louisiana.
— Wanda B.
September 19, 2003
I personally think that $3600 is insane, unless you were in surgery for
like 10 hours. It is billed in 10 minute increments. What I would do is
call some of the other anestheology places in the area and as how much they
charge per base unit. Then call this doctor and ask the same thing.
Anesthesiology bills are billed in a base units and additional base units.
Each surgery procedure code has a nationally determined amount of base
units and a doctor can not bill for more of those unless there are specific
items that make you higher risk. For my open RNY there were 6 base units,
which would be the same if your surgery was the same procedure code. Then
he was allowed to bill with a #3 modifier code on the procedure code
because of the morbid obesity and risk etc. The last thing they are
allowed to bill are time units. Time units are in 10 minute increments.
My total bill was $1,640. It broke down into 6 base units and 14 time
units for a total of 20 billable units at $82 each. I already knew before
surgery that the doctor billed at a higher amount per base unit that my
insurance would pay but I knew it would be less than $200 for me.
<p>The initial bill was not paid in full. BCBS paid $1453 which left
a balance of $187. I knew it should be closer to $100 so I questioned
whether they factored in the P3 modifier, which allows a higher amount to
be paid on the base units. They had not. So when it reprocessed I ended
up with a balance of $101 to pay. Considering other than my yearly
deductibel and co-pay, that is all I paid of my surgery, I was very
pleased.
<p>Anesthesiology bills are very strange and don't let them push you
off when you call. I suspect if you check around your doctor is either
billing WAY above the going rate or has billed for way too many time units.
If you had LAP RNY then you will need to ask what the base units are for
that procedure and adjust the math. Based on your bill, if my doctor had
sent me that bill (at the $82 per unit he bills) it would mean I was in
surgery for 38 time units or 380 minutes which is 6-1/3rd hours. If you
know you were in surgery less time then make them prove to you what makes
up that bill. His cost per unit may be higher but it would have to be more
than double what mine was in order to reflect a 2-3 hour surgery which is
what most are. You can also get a copy of the surgery report from the
hospital which will tell exactly how long your were under anesthesia. If
everything confirms that he is way overcharging for the area and/or has
billed the wrong amount of time units then tell them to take a flying leap.
The $2200 is way plently. I'm guessing he is billing way to high per
unit. Also find out if he billed with a modifier code, because if he did
and your insurance company missed it, reprocessing with this modifier
factored in will increase the payment from insurance.
<p>Can you tell I've had 10 surgeries. LOL With the exception of 1
surgery, I have never had my anesthesiology bills paid in full the first
time through. However, by the time I was done only two ended up with small
balances and the only one I had to pay was the $101 from my WLS. The other
one was written off, which was like $50. Good Luck and feel free to
contact me directly if I can be of any help.
— zoedogcbr
September 22, 2003
Actually anesthesia is billed in 15 minute increments, not 10. I paid
medical claims for 15 years and know this from my previous background. You
should contact your insurance company (if you have a PPO plan) and find out
if that group of anesthesiologists has a contract with your insurance
carrier. If so, you shouldn't have to pay anything more then what your
plan indicates. If they don't have a contract with them, I would let the
insurance company know they are balance billing you and ask if the
insurance carrier can make an additional payment to this provider since
they are not in the PPO network. Some carriers will since you have NO
choice who you get as an anesthesiologist when you go to the hospital.
Some carriers will pay more due to this. However, the anesthesiologist
seems to be charging an excessive amount. I was in surgery for about 3
hours and the total bill was $1100. I would ask them to send you an
itemized bill with how they come up with $3600.
— Patty H.
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