Hi! Would you help me with Houston ISD- AETNA issues, please?
Hi. I didn't even know the TX forum existed before the Houston conference. I have been posting on the RNY forum, but I have a region specific question that I wonder if someone could answer for me. I promise to begin reading and posting here, too, and not just get my answer and go. :)
I would have sworn AETNA told me that my total cost of surgery was about $3000: $1500 from my health fund, and another $1500 on top of that. My surgery was in June, and a couple of months ago I got a bill from the hospital for $7000+. Are they supposed to write that off? Am I really responsible for this? I've called both the hospital and AETNA and the pat answer so far is that I am responsible for this. I am a teacher, and really this amount is much more than I can handle in any sort of timely way. I'd appreciate any insight you can give me. Thank you in advance.
I would have sworn AETNA told me that my total cost of surgery was about $3000: $1500 from my health fund, and another $1500 on top of that. My surgery was in June, and a couple of months ago I got a bill from the hospital for $7000+. Are they supposed to write that off? Am I really responsible for this? I've called both the hospital and AETNA and the pat answer so far is that I am responsible for this. I am a teacher, and really this amount is much more than I can handle in any sort of timely way. I'd appreciate any insight you can give me. Thank you in advance.
As a single footstep will not make a path on the earth, so a single thought will not make a pathway in the mind. To make a deep physical path, we will walk again and again. To make a deep mental path, we must think over and over again the kind of thoughts we wish to dominate our lives. -- Thoreau 
I am a retired teacher with Aetna TRS Care. My insurance plan is different from yours because I am retired. What is the deductible and maximum out-of-pocket expense for your insurance plan, and what percentages are paid by your plan? Is the facility where your surgery was performed an in-network hospital? My surgery was performed at St. Luke's. My hospital bill was over $46,000, but after the insurance negotiated adjustments, my total out-of-pocket cost for the hospital was around $1,130. What are your plan specifics?
Is the hospital "honoring" the negotiated wite-down with the insurance co? In the past, I have been told theoretically they are supposed to honor the contractual adjustments, but "can" bill for the entire amount. I am not saying that is what has occurred in your case, but I can't imagine the huge discrepancy.
There is a difference between in network and out of network hopitals and Dr.s I have used both. With my revision I went with the in network and had to pay minimal compared to about $6.000. When I was admitted both took their amount before I could be admitted. There might be a problem with coding if so talk to them and have them resubmit.. There is a credit card from CareNetwork you can get or check out the credit unions they have the best interest rates. Good Luck.
Miss Jean Thank you both for your replies. I will find the info and respond here in more detail later this week or this weekend. I am not posting much during the week because I get home late, etc. Thank you very much,
As a single footstep will not make a path on the earth, so a single thought will not make a pathway in the mind. To make a deep physical path, we will walk again and again. To make a deep mental path, we must think over and over again the kind of thoughts we wish to dominate our lives. -- Thoreau
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