$80,000 for a hiatal hernia repair?!? And I am self- pay!
**WARNING**
THIS IS A RANT!
THIS people is why health insurance premiums keep going up and benefits keep going down. Insurance companies and employers cannot afford to keep paying these costs. They have to get the money from somewhere, that would be the premiums people pay in. If insurance companies don't agree to these rates that providers want to bill, the doctors and hospitals threaten to go out of network, which hurts not only the insurance companies, but the patients as well. People think it's the big bad insurance company. Take a look at this scenario and tell me who is in the wrong here?
/rant
I would go over all the bills with your surgeon's office and the insurance company. People make mistakes and also insurance billing is complicated so if you don't code things exactly right, it gets all screwed up. I bet you can get everything corrected and fixed and not only not owe anything but maybe even get some money back.
HW - 225 SW - 191 GW - 132 CW - 122
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I've requested the clinic send me all the detailed bills that were submitted to the insurance but after an hour long talk with the practice director late yesterday it is very clear that there was nor mistake just what I consider unethical billing practices. Is seems that if they bill the hernia repair as the primary surgery the insurance pays them about twice as much as if it were properly billed as the secondary surgery being performed at the same time as the sleeve. One thing I am going to look into carefully is what insurance would have paid if I had a policy that covered the VSG as well as the hernia repair. That is really the comparison that looks at apples vs apples in this case. You are so right that it is complicated!
Well, just make sure how they bill doesn't change your bottom line unless it makes it smaller.
I was self-pay and I had a hiatal hernia repaired and it didn't change my self-pay bill at all and nothing was billed to my insurance for it. I thought about submitting the bills myself to see if I could get some money back but in the end it was all too complicated and I did get to save about as much on my taxes as i would have gotten back (and, if I got it back, I wouldn't have been able to deduct medical on my taxes as I was very close to the limit already and that would have put me under it.)
All the practices do everything so differently and the insurance companies aren't blameless because a lot of times they set it up so that it's in the best interest of the practice to be unethical.
HW - 225 SW - 191 GW - 132 CW - 122
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My surgery was march 5th and I've been stalking my BCBS website to see what I'm charged and what insurance deems I owe for VSG. So far, anesthesia $2127.00, my surgeon herself billed $3200.00, her assistant M.D. Charged $643.00, and some other name billed me $149.00 for the day after surgery, maybe the X-ray? Nothing else has come in to BCBS in about 5 days now. I wonder if this is it???