insurance help

Oh well I am new here, but I like what i see so far, I did my surgery on march 31, 2014, was 251lb now 225, I don't know if it is slow or fast.

what I need help with guys,

I was told by my surgeon that my insurance covered everything before my surgery, but 2 months after the surgery I received a bill from my surgeon telling me that I am owning all the payment (all of it) for my surgery, I am saying more than $12,000. that my insurance did not cover it. how can you let me go throw surgery only to tell me after 2 months that it was not covered. I don't understand how they will tell me that my surgery was approved by my insurance and now, "no they are not paying for it". what do I do, where do I start. I don't want to mess up my credit, can anyone give me idea what to do. the worst is that I don't have that insurance anymore. just stopped working for that company.

I want to call the doctor office but I really don't know what to tell them. I am so mad at them that I don't know what to do.

thanks Guys for reading,

Rose

So your surgeon told you the insurance company approved the surgery but you didn't confirm that with your insurance company?

Well, I would call the insurance company now and ask if they ever approved it in the first place.

Did you not get an approval letter from the insurance company before the surgery?  Not that I care to much for my insurance company Cigna, but they always send me a letter stating what is approved and what is not. 

I would call the insurance company anyways whether you have them still or not. 

Contact the insurance company.  It doesn't matter that you don't have the same insurance now - you had it on the dates of services.  It could be a simple paper-work issue.  Generally speaking, when an insurer denies a claim, they will send you a notice stating the claim was denied and why it was denied.  If you didn't receive notices of denials, how could you "fix the problem" or appeal?

Most surgeon's don't do the surgery unless they have insurer's approval "in hand" - something's off here.  It's the surgeons that submit the paperwork to insurance for approval -- did they?  If so, when, and what was insurer's response?

Good luck to you in resolving this issue.  Hope you'll keep us posted.

I agree with your other posters,something is off. It may. Be that your surgeon is trying to get the extra money ,that he had not contracted for ,with the insurance company,from you. He is not allowed to do that per his agreement with your insurance company. 

Doctors contract a much lesser price with insurance companies,than they really want to. Make and some of them will try to double back on the patient to get the rest of he money they really want. 

Did your insurance cover the hospital bill? The anesthesia bill? Definitely go online and check your EOB and see exactly what was and was jot paid. 

Gl

I just have one comment about this and am having trouble right now about it.  If you have Medicare, which I doubt if yours was thru your employer, they will sometimes approve the surgery and then go back and audit it and reverse their own decision and make you pay.  I will make sure everything is in writing if and when I ever get it approved but I have to get my band out first with this surgeon.

I am new too and I haven't had my surgery yet. But several years back I had a surgical procedure to remove my varicose veins.  I too was told that it was covered by my insurance and a few months later got a bill for the entire procedure.  I called the dr's office and had them look into it before I called my insurance company.  It turns out that the billing person just put in a wrong code and insurance rejected it!  So instead of looking into why it was rejected, they just sent me the bill!!!  The billing person was giggling about her error, and I'm like, thank's for the near heart attack!!!  So call your surgeon's office and make sure they didn't make a typo...I had a doctor tell me that it's easier to get insurance to pay than most people.

This isn't something to be "mad" about, it's a common issue that a couple of phone calls will fix.

I don't know all the correct lingo, but the same thing happened to me with an anesthesiologist's bill.  I had a pre-approved procedure (had the letter in my hand) and everything was covered.  The anesthesiologist's contract with my insurance company had him getting $1,600.00 for his services.  He sent in a bill for $3,200.00, my insurance paid him the contractual $1,600.00 and his billing service didn't adjust the bill to zero ... they sent me a bill for the balance.  

I contacted my insurance company and they sent his office a letter basically saying that under his agreement with my insurance company, $1,600.00 was his full and final payment for services rendered and that he was not allowed to charge me anything over and above that.  I also called his office and let them know what the insurance company told me (be polite when you call, it's a billing error, not them trying to rip you off) and they had their billing service fix the mistake immediately.

Like someone else said, you were insured when you has the procedure.  It doesn't matter that you don't have that insurance now.  You were insured then.  

Call the insurance company first and see what they have to say, and then go from there.  It's probably a simple billing issue.  

Surgeons don't leave getting paid up to chance.  If they did the procedure, it was pre-approved.