Question:
GHI and Out-Of-Network Lap Band Surgery
Has Anyone ever went to an out-of-network doctor? If so how did it work out fo you. I really want to use NYU. I feel really comfortable with this team. — Sciteach (posted on November 15, 2008)
November 15, 2008
When you say "how did it work out for you", are you referring to
financially? If so, that all depends on your insurance coverage and the out
of network benefits they provide and if they provide them. I can tell you
that if you go out of network, be prepared to pay alot more than if you had
stayed in network since the surgeon, hospital etc can balance bill you any
amount not covered by insurance up to their normal charges. Not sure if
this is the info you're looking for since you weren't specific.
— [Deactivated Member]
November 15, 2008
I was a self pay for surgery, but in other circumstances I have gone to an
out of network facility and doc and the charges were pretty significant.
If you can afford it, go with who you are most comfortable with. It is
very important that you "go with your gut"- no pun intended.
Best of luck,
Dawn Vickers
— DawnVic
November 15, 2008
I am in CA and my doctor is out-of-network for all insurance. He is head
of Cedar-Sinai lap surgeries and was hand picked by a doctor friend of mine
for me. My insurance Anthem Blue Cross PPO covered what they would
normally pay for the surgery and I paid the rest. They broke the fees down
to surgeon fee and hospital fee. The hospital was in-network, so they paid
the whole hospital fee.
— SharonZ
November 16, 2008
I retired from NYC to Raleigh, NC. I did not have the choice except to use
another surgeon. I had RNY at Duke. BCBS picked up everything for the
hospital (I paid my deductible) but GHI only paid about 25-33% of doctors'
bills. I had two hernias repaired at the same time as my RNY and my
surgeon's bill was $16,000!!!! GHI paid $4,000. I am appealing their
payout. I was/am in shock!!
Sincerely,
Rena
— RenaMansi
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