Now that I am one month post-op, statements and ‘Explanation of Benefits’ have started to arrive from the hospital and my insurance company. Although my insurance covers 80% of my Lap Band surgery, I was intrigued to know what the large amounts money, submitted to the insurance company, were actually for – they are listed on the ‘Explanation of Benefits’ under the nondescript heading of ‘Service’. I called the hospital and asked for an itemized listing of these services, which the hospital provided.

Being a non-medical person I do not understand what the majority of items are, but a couple of things did catch my eye.

# 1 - on the statement for my pre-op testing there is a double charge for an Electrocardiogram – same date, same service code and same amount of $348.50.

# 2 - again on the pre-op testing statement, I see my urine was tested for pregnancy. On the paperwork I filled out I listed all surgeries, which included a tubal ligation done 25 years ago! Due to the fact that I have not become pregnant in the last 25 years, I take this as good proof that the tubal ligation has worked and that it is highly unlikely I would be with child now! This, and the fact that I have been post-menopausal for the last twelve years and I am nearly sixty one years of age, I see as almost certain proof in ruling out the possibility of me being pregnant and yet I was still tested. Cost for this test, $135.00.

#3 – if one pregnancy test wasn't enough, there is another charge on the statement (this time on the date of my surgery) for a second pregnancy urine test. This is a completely false charge, as I never gave my urine to any one on that day. In fact, on the day of my surgery I had very little urine at all. This was because I arrived at the hospital before 5:00 a.m. and my surgery was delayed and delayed and I did not go into the O.R. until 7:00 p.m. that evening. As I had had my last drink at 11:00 p.m. the night before and did not get a drink of Water until 10:00 p.m., this meant I went 23 hours with a sip of water passing my lips. I certainly would have remembered giving up a urine sample - they would have had to squeeze it out of me! Another charge of $135.00.

To my reckoning that is a total of $618.50 of wrong/unnecessary charges, and that is only on the few things I could figure out what they were. It makes me wonder about all the other items listed on this 4-page statement!!!! I will be calling the hospital and my insurance company tomorrow.

Edited January 31, 201016 yr by Vivinthewoods

Love it. They really do find every possible way to milk the consumer don't they!

Good for you in checking your statement. No wonder our health care system is such a mess. You are paying part of that over charge too aren't you? Since you still pay 20% you are paying 20% more for things that shouldn't be there.

I applaud you for checking and following up with it.

I agree with you about the pregnancy test. Its "required" that the hospitals do it. I am 55 and it made me laugh when I saw it on my itemized list of services. I think its yet another cost that hospitals add to their huge bill so they can get insurance to pay. No wonder premiums for medical insurance is so high.

"Love it. They really do find every possible way to milk the consumer don't they!"

Good for you in checking your statement. No wonder our health care system is such a mess. You are paying part of that over charge too aren't you? Since you still pay 20% you are paying 20% more for things that shouldn't be there.

I applaud you for checking and following up with it.

Elcee - Yes, the hospitals sure do try to sick it to you.

Ocotillo - Yes, I will have to pay 20% of the over charge, but I will try for an adjustment. I'll let you know if I'm successful.

I'm not knitting any booties yet!!!!!:thumbup: