Self Payers...
I'm still hoping my insurance will authorize my grievance/appeal; however, if they don't I will self pay on 12/20!! So Excited!!! My question... I have received a price from my surgeon, hospital and anesthesiologist. Should I have these prices in writing? I know the hospital is a set price for 3 days, and I know the hourly rate for the anesthesiologist. Should my surgeons price be "all inclusive" if something (knock on wood) goes wrong and he has to remove my spleen or whatever! Also, should his fees cover a year of post op? How were your costs handled, if you don't mind me asking.
My surgeon was up front in that the price covered a routine surgery and while he obviously would do anything needed while there, there was the possibility of additional charges should anything major happen. Though, I've never seen that be the case outside of complications which in general, the understanding is that as a self payer, one of the risks is that you are likely resposnible for complications.
My surgeon advertises a rate that is all inclusive for a standard procedure. It includes the hospital stay for routine surgery and all fees associated with him and the anesthesiologist. I did have to pay all three seperate but it was pre negotiated to exact amounts. IIRC it was $5000 to the hospital, $5200 to the surgeon and $790 to the anesthesiologist....may be a couple dollars off but I know the total that he advertises is $10,990. But nonetheless, he told me right from the start that this included only routine. He did also tell me that he always does a liver biopsy and that insurance covers it about half the time. If they didn't I would be repsonsible for the pathology side only, not his time. Ended up insurance did cover that in my case.
Summary: expect to pay additional for anything out of the norm.
My surgeon advertises a rate that is all inclusive for a standard procedure. It includes the hospital stay for routine surgery and all fees associated with him and the anesthesiologist. I did have to pay all three seperate but it was pre negotiated to exact amounts. IIRC it was $5000 to the hospital, $5200 to the surgeon and $790 to the anesthesiologist....may be a couple dollars off but I know the total that he advertises is $10,990. But nonetheless, he told me right from the start that this included only routine. He did also tell me that he always does a liver biopsy and that insurance covers it about half the time. If they didn't I would be repsonsible for the pathology side only, not his time. Ended up insurance did cover that in my case.
Summary: expect to pay additional for anything out of the norm.
Thanks for the info, Jason. My price is very similar: 6700 hospital, 2500 surgeon, 1890 anesthesiologist for a grand total of $11090. I feel like I'm getting a most excellent deal here in northern California. Well -- I am, as my surgeon and hospital are giving me an excellent self pay price. Fingers are crossed all goes well and it's a very routine, uneventful surgery!
I was self pay and it was $11,500 for the sleeve. $8000 for the hospital for up to 3 days and $3500 for the surgeon. It included pre-op classes, and one year of post-op visits. I had to pay for Psych Eval of $100 and pre-op lab work was paid by my insurance. Post-op lab work has also been paid for by my insurance.
Good luck with your insurance. All I can say is that $11,500 was the BEST MONEY I HAVE SPENT ON MYSELF. Would do it all over again if I had to.
Marlene