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What Next????????????????????? ???????

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shonette

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I received a phone call yesterday while I was in training at my job from my doctor's office manager. She called to let me know Dr. McCowan was not in network with my insurance company, but they have their application in process to become in network providers. I was speechless! :cursing:I asked her what you mean my doctor is not in network with my insurance company. I asked-day one before I chose Dr. McCowan to be my surgeon if he as in network with my insurance company. I was told yes he was. My husband included the high opp. plan so his benefits would pay 90%, and I would only have to be responsible for the remaining 10%. That is a big difference when you are talking about several thousand of dollars. After I have done every single thing required for me to do, I am being told this none sense by his office!!!!:) My insurance has approved me for this procedure and my pre-op is schedule on 7-14-10 @ 9:15 am and my surgery is scheduled to be on 7-21-10.

Due to unforeseen additional financial expenses, my procedure will be postponed for a later date. This is totally unfair and heart breaking news for me. Someone may ask how I not knew my doctor was not in network with my insurance company. I called and asked the insurance company and my doctor before this entire process was started. I was told by both parties everything was fine and 10% is the only out of pocket expenses I had to be responsible for. I started getting bills from my doctor's office with high balances. I was paying my entire portion up front before any visit or procedure was done. That was the first red flag, but I was told by the office manager everything was cleared up and corrected on their end. I started calling my insurance company myself to see what was going on around April when the second bill notice was mailed out to me. I was then told by my insurance company they accepted his insurance but at 70% instead of the 90% that I was originally told.

I was told several times by the office manager everything was being cleared up, but within 2 weeks of getting my band it's all been a lie. The difference of my 10% out of pocket and 30% is about $2500 additional dollars. I am not financially prepared to pay that due to some other financial obligations I have. I spoke with another person who works with Dr. McCowan to see if he will do my procedure at the 10% rate, because that was the original agreement. I am just praying something workout before my actually date. :smile2: I do have faith in God that he will and has always worked things out in my favor.

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If all else fells, ask them to put you on a payment plan. many will do this....I am on one myself......Don't give up and keep the faith

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Ugh! That has to be so frustrating!! I'm so sorry and hope that they can help you work it out.

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Ah the joys of medical billing. Well you have a few options... 1.) wait til it's worked out. 2.) hope they get it worked out and in good faith give you the surgery at the 10% rate and 3.) Get your surgery, let them bill you for the remainder and only pay your 10% if they cash it they're agreeing to your terms- you can put it in the memo or on the back of your check, etc.. 4.) Change surgeons - you're already approved, there's no real work for them to do, they'll be happy to have you. and finally 5.) let them bill you let it go 90 days, and as with all medical bills older than 90 days they'll be willing to give you a compromise - that is just enough to cover their actual costs. For example a 23000 bill being settled for 2300, or my mother's 892 ambulance bill being settled for 90, etc.. medical bills are ALWAYS trumped up, and they're always happy to get something.

I know how frustrating this must be for you, but you do have options.

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So so sorry to hear about these frustrations at this point!! Glad to hear you have faith!! I also agree with ymjackson..she lists some good options there. I know other surgeons would be will to take you that is if there are others in your area. It might be best to change if there has been such a sour taste already....

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My insurance is covered at 90% as well and it's all on the back end billed to me. I was told I can make monthly payment if I need to. Check to see if this is an option for you?

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I was so pleased to find out yesterday afternoon my doctor was willing to go along with the original agreement 90/10. I do thank God that he always works things out in my favor. I have learned not to allow my frustrations to cloud my judgment.

Therefore, I will have my surgery as planned on 7-21-10. My pre-op time has changed to 9:30am because there is so much I was told need to be done. I am a little nervous but I guess that is normal. I do thank God I will be banded. This has been a 2 year phase for me and now it will be a reality. OMG!!!!!

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