Question:
Insurance Questions - Payment and Employer

I read something about surgeons accepting what the insurance company paid and writing off the rest of the cost. But now I can't remember what the person called it - she had a term for it. I definitely want to ask my surgeon if he is willing to do this and save myself $2,500. Anybody know the term? Also, does anybody know if Human Resources will need to be told the nature of my surgery? I'd prefer nobody at my office know what I'm doing. I plan to just say abdominal surgery, but I don't want paperwork coming into HR approving my leave that says gastric bypass. Any HR experts out there?    — [Anonymous] (posted on November 7, 2001)

November 6, 2001
Legally, you don't have to say anything to your employer. Furthermore they have no legal right to ask what kind of surgery you're getting, and they should know that. I work for a fortune 100 company and it was no problem whatsoever. Just make sure on your paperwork that you ask you Doctor to be vague. Good Luck!
   — Deborah W.

November 7, 2001
Insurers never disclose confidential, privileged info to employers. Your "secret" is safe. I t9ld my co-workers that I was having "gastro intestinal surgery" and that sufficed. I did eventually tell the truth because when people noticed the drastic weight loss, many pf the people I considered friends became worried. I had to alleviate their fears. Surgeons are paid by fee schedule if they are "participating providers" with a particular insurer. That means they must accept the "fee schedule" payment and they can't balance bill you. They write it off as a contractual adjustment. If no such "participation" agreement exists, the physcian can balance bill you. Many surgeons won't do this if you explain that there are financial hardships.. some will bill but set up a pay schedule. You really should get this info directly from your insurer...in writing if possible....before you bring up the subject with your surgeon. You can also ger this info from the Benefits office where you work. Also...if your insurer doesn't authorize the surgery, you would be responsible for the whole amount.
   — [Anonymous]