Aetna Rates for Anesthesiologist

[medmgr 4]

Just got hit with an unexpected today - found out that on my company Aetna plan where it says they will cover 100% of WLS if you use one of thier Centers of Excellence, is not really 100%. Apparently (and I called Aetna to verify - the lady I got had to go ask someone else cause she did not know) the Surgeon and the Anesthesiologist are not covered at 100% - they are 80% covered. The Surgeons office called me up and said I will need to pay $523.36 (my 20%) but I have no idea what the Anesthesiologist is and what I need to pull from savings.

Does anyone who has had thier sleeve done know what the Anesthesiologist "agreed" rate is with Aetna?

Thanks!

[wishes 125]

That is so weird. Why are the surgeon and anesthesiologist only covered at 80%?

[medmgr 4]

Yes it is weird, and painfull. It would have been nice knowing it more than the day before I have to write the checks!

Don't get me wrong, I am big time gratefull that it is covered at all. So many people on this forum have to pay 100% and then have to fly across or out of the country alone for thier surgery.

[Bryn 3]

I wouldn't mind paying $500 for the anesthesiologist rate, I got hit with a bill for $4,100 from the anesthesiologist.

on the bill it says that the insurance company did not respond, whatever that means. I'm calling them up and asking them to resubmit.

i find it absurd that the surgeons office nor the insurance company wouldn't follow up with this prior to surgery. I got hit with 2 bills grand totaling $10,000. If I wanted to pay $10,000, I would have paid out of pocket

fight it if you can, have them resubmit it. do whatever you can.