UPDATE ON So pissed right now!!!!!! (better news)

OK So. I just got off the phone with the HEAD coordinator over at the billing place. The person who called me this morning was NOT the normal person they have there any other time, she was just subbing. She was reading TRICARE STANDARDS cat-cap stuff. I am Tricare PRIME. I had called Tricare just to be sure that what I was originally told was valid- it is not 33.00 it is 25.00 (argghhhh, not complaining about that) Tricare told me that I had NO CATCAP at this time.
The billing place called me back after I had been trying to reach them for like an hour and said that she was so srry that I was told a basic lie. I questioned why the person who had told me was the one who called and made it seem like SHE was the one in charge of my case. But ok to make a long sotry short MY SURGERY IS STILL ON. I can pick my self up off the floor and go back to my happy self. Word of caution/advice: QUESTION QUESTION QUESTION if something doesn't sound right with your insurance. I had questioned over and over with the nurse at the surgeons office if she was absolutely sure about my co-pay (thought it was 33.00) and she told me yes. So it is all good now. I will be fine....


(original post)
Ok so everything is rooling right along then BANG there is another wall. At my final pre-op appt at the surgeons office I was told all I had to do was pay 33.00 co-pay when I went in for my preop signing and final paperwork. Ok not bad right? WRONG..... I get a call today that I will probably have to pay 2800.00 plus the 33 co-pay before they will even give me the paperwork to sign for my surgery. I did not do all this only to have this fly up into my face at the last minute. i am so mad right now I could spit nails. NOTHING was said about this, I asked several times if they were sure the 33.00 was all I had to pay and BOTH nurses over there said it was definate on the 33.00 and NOTHING else.

Holy Cow! Did I read earlier that you have Tri-care prime? UH I need to call and make sure that I don't have a copay or anything..I did have to pay a 300.00 "program fee" that wasn't covered by Tri-care but that's all I am aware of....OMG I feel so bad for you...did they say what the money is for and why its not covered by insurance? I have heard that some insurance does pay 80/20 so is that your 20% maybe? I could be all kinds of wrong but, I would be pissed too!! 

No it is my catastrophic cap- Apparently I haven't used 3,000 in order for tricare prime to cover it all. I pay a 12.00 copay each doctor visit I do and i havent even hit 300 of that.

For anyone who has a CAT CAP- use it all up before major surgery because you are liable to get screwed.

all insurance co. are a billion dollar organization. they rip everybody off. i know thats not alot to have to pay for suregry but when u dont have it . you just dont. what makes ppl more mad is when u r told something . u believe them. and i hate when u cant trust what ppl say .
alot of ppl need to get their heads on straight when it comes to dealing with ppl having WLS and what they tell us . i hope u dont have to pay that . i would be calling nd asking why they told you one thing and they are doing another .

This happened to me but I was kind of aware it MIGHT happen.  My doctor's office required that my deductible and max out-of-pocket be met before my surgery.  It was a total of $3200 but with the EGD and several other tests that had been run I think I ended up paying around $1200 of it.  THEN the hospital required another $500 deposit even though everything else had been paid up front.  I thought I would never get that money back from them after my insurance paid.

Well, I hope that it works out for you! This sucks, finding out after you have a date!!! You have also had to wait and take awhile to get this far!! I have asked a ton of times if I would have to pay for anything out of pocket, and told just the program fee. This sucks, but don't let it get you down, its another stumble and it will all work out in the end...I know easier said than done..

I am going to call tri-care and find out exactly what I am supposed to do. I asked several times about the co-pay and was told the same thing everytime 33.00 and NOTHING else. It is even on the paperwork that was all thatw as expected. But if they like playing these games then I will play right back. There is NO sense in the way people get treated. We have paid our dues EARLY every quarter and not once ever had an issue. Not until now.

My original paperwork from my surgery center suggests a call to the hospital discharge office for more information about fees.  Everyone's insurance policy is different.  The clerk at my hospital was very helpful and even called my insurance company for more information.  The minimum payment at the pre-op appointment would be $1500 (90/10 insurance), and then they would bill me for the expected additional $200+.  Then she remembered to ask me about my max out of pocket expense, luckily mine is awesome insurance max oop is $500) so I won't have to pay the $1500, just $446.  I am sure there will be other expenses incurred at the hospital that won't be covered, it seems as though there's always something that pops up that insurance resists paying.  The other thing I have to look forward to is the tax...insurance doesn't pay tax and in Hawaii we have a General Excise Tax that applies to everything....even medical care.  So I know I have that little bill in the offing as well.  

I felt that the clerk in the hospital discharge office really had a good grasp of the process and was able to give me "real" information about my situation.  I hope other pre-ops get someone similar on the phone!

Sara in Maui

 I am glad that you got everything straightened out!!!
Also..thanks for posting this because it made me double check on MY insurance and co-pay. Fortunately the initial info I was given is correct. whew!

YAY! I am so happy for you!!! I was thinking that sounded like standard not prime! I got an EOB from Tricare in the mail today and it says I have made like 1200.00 towards my CatCap and so I called just to make sure it was right..no copay or anything for me! Woot! I am soo happy happy for you, you have waited and worked so hard for this for to long! Congrats and soon we will be on the other side of this!! I have never been so ready to be a loser in my life!

Hope