Surgeons assistant???

Minadina
on 9/12/16 11:04 am

I've read a few dated post on this topic, so I just wanted to post and get some fresher responses. And as just a heads up to those who are still pre-op. I just checked my claims and the phantom "assistant surgeon" showed up...out of network of course. I literally have no clue who this person is, didn't meet him the morning of surgery either. I was not told prior to surgery that their would be an assistant. The hospital had my insurance information beforehand as did my actual surgeon. I feel a lil blindsided. I mean perhaps it's common sense, but I've never had major surgery before. I assumed that I would have been notified beforehand if anyone associated with my surgeon or hospital weren't in my network. So now it says I have to pay this assistant surgeon 12 grand. Which is a little weird to me, considering how my actual surgeon only charged 5 grand. How does the assistant cost more than the surgeon??? I haven't received a bill from said surgeon yet, but I like to be prepared. 

I see some people said something about appealing to the insurance company? Does that work?

Kathy S.
on 9/12/16 1:21 pm - InTheBurbs, XX
RNY on 08/29/04 with

Hi Minadina,

Sadly this is becoming more and more common, not just for WLS but for all medical procedures.  Here is a great article on it.

http://kff.org/private-insurance/issue-brief/surprise-medica l-bills/

Find out if where you live has passed any laws to protect you from this.  Also, contact the facility and fight this.  I had this happen once and fought the hospital and they ended up writing it off.

Congratulations on your surgery and we look forward to your updates!

 

 

HW:330 - GW:150 - MW:118-125

RW:190 - CW:130

Sparklekitty, Science-Loving Derby Hag
on 9/12/16 1:23 pm
RNY on 08/05/19

Who says you owe $12k? The hospital? The insurance company? Your surgeon's office?

Call the billing coordinator at your surgeon's office and ask for more information. They can give you some starting information, and you can call your insurance company to follow up if needed.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

Minadina
on 9/13/16 9:58 am

According to my insurance claims processed they were billed $12k by the "surgeons assistant". They only paid them $120 because he's not in my network. Now to date, I have not received a bill from this "phantom assistant". But I understand it to be my responsibility to pay what the insurance doesn't...not that I'm paying anyone 12 grand. But still, I guess I'll just wait and see what transpires. 

sheriberi29
on 9/12/16 2:10 pm - Cleveland, TN
Sharon SW-267
GW-165 CW-167 S.

on 9/13/16 3:17 am, edited 9/12/16 8:17 pm - PA
RNY on 12/22/14

If your surgeon needs an assistant, then your surgeon can pay him.  Your surgeon might not even know someone else is billing you.  Might be a scam.

 

Sharon

Minadina
on 9/13/16 10:00 am

My thought exactly. lol! I'm like what assistant, I didn't meet an assistant on the surgery morning and I'm pretty sure I met everyone in the room. I was kinda wondering if it was one of those scams that people tack onto large insurance claims in hopes of getting paid. Guess we'll see what happens.

Valerie G.
on 9/13/16 9:20 am - Northwest Mountains, GA

I think you're well in your right to be asking questions.  That charge is ridiculous.  Keep pressing!

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

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