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Surprise Bill!

When I did the pre-op, then registration the day of my surgery, I was told I had nothing to pay other than my co-pay. Yesterday I had a letter from my insurance company saying that I owe the Dr $4,308.45 (the amount they wouldn't cover). The hospital/Dr charged my insurance over $82,000 for my lapband but insurance would only cover a little over $76,000. Of course neither my insurance nor dr's office is open on the weekends. Talk about shocking mail!!

(I do have my pre-op paper work that says "method of payment for surgery... " and cost of surgery "$0"

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  • Frankly I am shocked your insurance paid a much as they did, that seems incredible to me! My surgeon billed around the $20K mark and received about 65% from insurance but I wasn't responsible for any

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$82K is a shocking amount to bill insurance. I was self pay and paid only $16K. I'd be screaming mad @your Dr and start using words like insurance fraud....how can a self pay be so much less expensive than a surgery covered under insurance?

I wouldn't panic as most doctors bill more then insurance companies pay without expecting full payment. Kind of the price for accepting insurance. Of course call doctor on Monday but try not to stress until then!

My surgeon/hospital only billed approx $20k... the amount billed is absolutely ridiculous. I would be on the phone asap Monday!

I happen to totally agree with the above post but figured I may not know some particulars about your surgery LOL!!

  • Author

I couldn't believe the amount billed either! I knew self pay wasn't that much so when I saw it I was thankful I didn't have to pay it.. Then I get this one.. :( Hope it is just a "write" off amount. I wasn't expecting to pay this much.

Frankly I am shocked your insurance paid a much as they did, that seems incredible to me! My surgeon billed around the $20K mark and received about 65% from insurance but I wasn't responsible for any of the difference.

The dr often over bills and wouldn't worry until your DR send a bill to you I was afraid I owed too but never got a bill from DR. I personal wouldn't call DR until he sent a bill.

The dr often over bills and wouldn't worry until your DR send a bill to you I was afraid I owed too but never got a bill from DR. I personal wouldn't call DR until he sent a bill.

I agree

I would request a itemized invoice, where there other medical problems that needed treatment?

  • Author

The implant (band) .. $42,537.10

OR services...............$28,551.90

Recovery room...........$1616.30

Med-Sur-Gy (whatever this is) $2,085

Pharmacy ...................$899.00

IV solutions..................$1006.50

MED/SUR supplies...... $183.30

Sterile supply.................$2350.70

Lab..................................$6.00

X-ray (barium swallow) $770.20

Anesthesia........................$223.70

Drugs...............................$1792.70

This is the itemized bill.... I had1 hernia repair (required 1 stitch) .. The guy did hit my voice box going in so I was hoarse for a few days.

Guess I might wait to see if the Dr sends me something.. Or call insurance first

Umm, wow. Sounds like the surgeon/hospital is ripping off your insurance. If they do send you a bill, I would contact them. Normal costs billed to insurance seem to be between 20k-30k, so this guy has got three times that amount.

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