Question:
I live in KY, had Roux-en-y done by LAP at Univ. Hosp. in Cincinnati & have BCBS FEP.

My surgeon is preferred & so is the hospital. I would like to hear from others who had the same circumstances, to tell me how much they were required to pay of the surgeon's bill, the hospital bill and the anesthesiologist bill. Thanks.    — Cathy D. (posted on January 21, 2003)

January 20, 2003
From my limited knowledge of insurance I can say that if you use your preferred surgeon and hospital usually you are only responsible for and deductibles, copayments or coinsurance amounts. ( let say your plan has a deductible of 500.00 and an out of pocket of 1000.00, then you would pay exactly that $1500.00 total for the entire bill because then your plan kicks into paying 100%.) then the anesthesiologist may or may not be part of the preferred contract so you would pay what is over the usual and customary rate. So example his fee is $1000.00 and insurance pays 80% of ucr lets say ucr is only 500.00 then they would pay $400.00 and you would pay 600.00 for the total bill of $1000.00. Now if anesthesiologist is willing to accept usr you would only pay 100.00 for total of $500.00 and he would write off $500.00. Don't forget the radiologist and pathologist for any blood work or xrays. Insurance is a complicated business, my best sugestion is read your handbook and call the insruance dept at your surgeon's office they no all the ends and outs and can tell you how the anesthesiologist is set up as they usually use the same anesthesiology team and are very familiar with there practice as well. Then you have the co-surgeons also. Good Luck.
   — Jeana S.

January 20, 2003
I have Federal BC/BS and had open RNY last March. My ou of pocket for the psych, preop, surgeon, hospital and everything was about $1100.
   — jan M.

January 21, 2003
I also have fed BCBS and had surgery in July. I paid $1000 to the surgeon, slightly less than $200 to the anesthesiologist, $100 to the hospital and about $300 for pre-op testing (mainly because I had not yet met the deductible for the year). So my out of pocket was around $1600. All my docs and facility were preferred providers.
   — jutymo

Click Here to Return