Dont you love when you talk to your doctor about Price
I'm guessing he was only talking about the price he charges to perform the surgery. He probably doesn't know what the hospital charges for everything.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
If you have an online sign in for your insurance, they sometimes have a break down of the explanation of benefits. You can also check on your deductible. I'd start there so you have a clear answer from the insurance side before you talk to the doctor and hospital. Good luck!
My posts are for general information and do not constitute medical advice. They should not serve as the basis for any medical decision by you. Call your physician for advice. HW 248 SW 233 CW 155
That sucks! It sounds like it might be a deductible? But appeal, appeal, appeal!
I just checked my insurance claims online and it looks like the hospital billed around $110,000 (!!!), my insurance paid about $37,000 of it, but I don't owe anything more. What happened to the rest? I don't understand medical costs and insurance AT ALL!
RNY @ Temple University Hospital, Philadelphia with Dr. Tatyan Clark 3/18/2014
The difference is the contractual adjustment that the provider agreed to accept from the insurance company. $18,000 sounds low to me, and it sounds like a price that would be quoted to a self pay (no insurance coverage) patient. In general, the doctor is NOT the best source for information on how much procedures will cost, and everyone bills separately. The surgeon (and assistant surgeon if applicable), anesthesiologist, pathologist and hospital will all bill separately. The amount you are being billed sounds like deductible and/or out of pocket maximum. Prior to going into any procedure, patients should educate themselves on their insurance coverage and what their expected out of pocket amounts will be. In fact, the WLS practice that I went through had a 3 page document that patients are required to complete, which involved contacting our own insurance to verify coverages and out of pocket amounts. If this claim was processed according to the original poster's policy, there is nothing to appeal. He will just need to see what kind of financial assistance or payment plans are available to him from his provider.
