Question:
Should I pic another Surgeon?
I went for my consultation and had to pay up front and my insurance company was going to pay me back. Well the ins. co says that they will give back part and that the Doctor is in network so they have to give an in-network discount. They Surgeon's staff is telling me they do not accept in-network discounts and that they mailed out a "Oppt. Out" letter to ALL ins. co. I am so lost do I need to fight harder or should I look for another surgeon? — Sabrina Plunkett (posted on July 27, 2003)
July 27, 2003
As a person who started out with a doctor who's "not in any network
anymore", and switched later to one definitely IN my network, I
personally would suggest you cut your losses now and call your insurance
co., get doc names from THEM, then confirm when making your appointment by
phone that they are, still actually IN network. You'll ultimately save
about 2,000 most likely, and possibly more.Good luck!
— Postop_nurse
July 27, 2003
I agree with Barb...get out while you can. If I'd not had an
"in-network" surgeon his fee alone would have been about 3 grand
more than after the discount...and the hospital gave a discount of over 10
grand for being in-network. I made sure all I "hired" were
in-network and I'd suggest others do too, if at all possible!
— [Deactivated Member]
July 27, 2003
I would definately find another doctor. I am double covered by 2 plans so
thankfully my surgery didn't cost me anything out of pocket. However we are
still paying for "out-of network doctors" and charges for
procedures "above and beyond usual, customary and ordinary" for
my son's ear tubes and some stuff for my husband. We have been paying on
them for a year already and will be for at least another year (we have
changed insurance companies and no longer have this problem). I know how
badly I wanted this surgery and would have died if I had to start over with
another doctor, but paying those extra charges is a MAJOR financial burden.
When we found out that we would have to pay the extra amounts I thought
ok--it won't be too bad, but the $200-$300 per month we are paying out
month after month really adds up. There have been lots of things we
couldn't do or needed (like car repairs, home repairs...) and have had to
do without. Stay positive and look to the future and look for a different
doctor.
— Kathy J.
July 27, 2003
If you stay with this surgeon you could run up some serious bills. If
given the opportunity to switch to a Doc within your network....take it.
That is why you have insurance. That was a great suggestions to call your
insurance company and have them suggest a surgeon they work with already.
Best of luck to you...
— teresa M.
July 28, 2003
The doctor's office should be able to tell you exactly how much you would
owe (or not get back). They know what their charge is for the surgery and
what insurance will cover. If you really like this surgeon and have total
confidence in him or her then a couple of thousand out of pocket might be
worth it to you. I know for my surgeon it would have been. If you would
be comfortable changing then find an in-network one.
— zoedogcbr
July 28, 2003
The last thing we need is to come up with funds to pay for a surgery our
insurance may cover in full. My only out of pocket expense was a psych
evaluation that was reduced from $300 to $150 when I voiced my concern with
the cost to the psychologist. I gave him the whole speel about being a
single mother taking care of my dad and our economy being how it was, etc.
All other expenses were co-payments. Before making an appointment with my
surgeon I confirmed he was in network with the insurance company and his
office. I also checked every doctor he recommended and choose only those
in-network. I sleep better at bight because of WLS and knowing I don't have
any expenses due to the surgery. I suggest looking at other doctors before
committing to the surgery unless you can afford to pay out of pocket.
$1K-$2K may not be much to you but I would prefer to use that money to go
shopping for new clothes! Good luck on your decision.
— Oneida H.
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