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A little confused as to what this will cost me

so i was sitting here paying bills and it occurred to me i had not been billed for any of my visits so far. i have received multiple explanation of benefits each showing me an amount due.. I've tried calling the billing office but have not gotten anyone to answer :( I have the High deductible insurance with Cinga who approved the banding as an out of network surgery - Have no idea what that means. Is any one else as confused as I am or am i the only one.. trying to figure out who the right person to call is :( I'm willing pay what ever but would be nice to know ahead of time..

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ok i called the office and they couldn't tell me what my out of pocket is going to me nor could they tell me what the total cost is? WTF i'm no longer freaking out over how i'll do with no food now i'm like WTF what if i can't pay - they don't seem worried but i am... i know the surgery will be over and one but i don't need that kind of stress.. She just told me to discuss it with the surgery center call to schedule the surgery :(

i was self pay so the costs were fully disclosed. You could ask for that cost to know the worst case possibly. Mr Dr. was very up front with the price. In fact that self pay price was mentioned at the beginning of the seminar i went to.

The Dr office will not know what your insurance will ultimately pay until they submit it. They have no way to know where you are in your policy and out of pocket max.

  • Author

i was self pay so the costs were fully disclosed. You could ask for that cost to know the worst case possibly. Mr Dr. was very up front with the price. In fact that self pay price was mentioned at the beginning of the seminar i went to.

The Dr office will not know what your insurance will ultimately pay until they submit it. They have no way to know where you are in your policy and out of pocket max.

that's the problem i ask what the full out of pocket cost would be if my insurance didn't cover me. she didn't know :( right now i'm just going to plan on my max out of pocket cost being met and be happy if less than that...

That should be a well known figure. With True Results it was 9866 and included a full year of follow-up. The plus of self pay if you can afford it is that you are usually on the HOV lane to being banded. No hoops or hurdles of insurance company imposed rules. I figure I am 50 pounds ahead of where I would be if they paid. Not to mention having a lot less stress.

  • Author

That should be a well known figure. With True Results it was 9866 and included a full year of follow-up. The plus of self pay if you can afford it is that you are usually on the HOV lane to being banded. No hoops or hurdles of insurance company imposed rules. I figure I am 50 pounds ahead of where I would be if they paid. Not to mention having a lot less stress.

thanks Gary that's how i felt i am actually going to True Results in Scottsdale and couldn't understand why they could not tell me. It's been a something I've asked before but wasn't too concerned as i wanted to see what my insurance would cover first. so based on your number i'm looking at meeting my max out of pocket for the year

I have a Cigna plan as well and once I reach my family deductible than my cost will be 20% (in network) of the contracted rate. You might want to find out from Cigna what the contracted rate is then it should be around the out of network percentage on your plan as long as your deductible is met. I also have found if you are a cash paying patient doctors tend to give a discount and will charge more to an insurance company. Hope this makes sense and hope you are able to find out.

Cash price and insurance price are two totally different things. My insurance company was billed over $43k. I doubt this was the amount that changed hands. I also doubt that if I had written a check that it would have been the amount I'd have been charged.

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