Jump to content
×
Are you looking for the BariatricPal Store? Go now!

hospital wants out of pocket amount up front



Recommended Posts

Wow, there's really interesting diversity evident in the way insurance companies are handling things. I think it's also another sign of the times, so to speak.

QueenBeeFla - that's ridiculous about your maternity copay - required or not, that's inappropriate. When I had DD (2008) I had two copays - my inpatient for when I was admitted to L&D, and then my daughter's inpatient copay effective the day she was born. I asked when I was admitted if I could go ahead and pay for both copays right then. They told me claims had to be filed through insurance first. I know that's bogus.

Share this post


Link to post
Share on other sites

I have Kaiser and I have relatively low co-pays except for emergency visits which are $100 a pop. But, bariatric surgery is $500 co-pay up front. I checked my coverage right away, first to see if they covered it, and saw the cost then. To me, it beats $10K out of pocket (on the cheap side) if I had to pay for it without insurance.

Good luck with your surgery, hope all goes smoothly!

Share this post


Link to post
Share on other sites

I didn't have to pay the hospital up front, but I did have to pay my surgeon the difference that the insurance didn't cover prior to surgery. Now I got a bill for 2600 from the hospital, can we say payment plan? LOL

Share this post


Link to post
Share on other sites

I am scheduled for surgery on July 18th. Today I got a letter from the hospital that said they confirmed my benefits and expect I will have approximately $500 owed out of pocket. They want me to pay this now or at the time of registration. I have had many surgeries and have never had a hospital ask for money up front. Has anyone else been required to pay?

yup me too, I had to give $10,000.00 up front and $5,500.00 to the surgeon up front. Yup this is common practice for self pay.

Share this post


Link to post
Share on other sites

My surgery hasn't been scheduled yet, however, I've gotten a call from admitting at Providence Hospital that Tricare covers everything except an $11.00/day copay. I can't complain too much about that. From what I'm gathering, I'm pretty lucky. Good luck to you!

Share this post


Link to post
Share on other sites

I had to pay 523.36 for my 20% copayment to the surgeon - I also expect to get a bill for anesthesiologist later. This caught me off guard because my insurance plan says the surgery is 100% coverage when done at thier centers of excellence... Funny how 100% coverage isn't :-/

Share this post


Link to post
Share on other sites

Sorry you have to pay, that stinks. I too have to pay some upfront costs for educational workshops, nutrition. It comes to about $900 and the insurance won't pay for educational sessions. That said, I was so afraid my insurance wouldn't cover any thing and that I'd have to self pay, I'm OK with it. I had set aside some money in a flexible spending account, FSA, assuming I'd have to pay the whole thing.

I am scheduled for surgery on July 18th. Today I got a letter from the hospital that said they confirmed my benefits and expect I will have approximately $500 owed out of pocket. They want me to pay this now or at the time of registration. I have had many surgeries and have never had a hospital ask for money up front. Has anyone else been required to pay?

Share this post


Link to post
Share on other sites

I am scheduled for surgery on July 18th. Today I got a letter from the hospital that said they confirmed my benefits and expect I will have approximately $500 owed out of pocket. They want me to pay this now or at the time of registration. I have had many surgeries and have never had a hospital ask for money up front. Has anyone else been required to pay?

i had to pay $3500 before they would schedule the date, but i am self pay. my surgery is on the 19th :) good luck!

Share this post


Link to post
Share on other sites

It's not just for elective surgeries that upfront payment is expected. My dh had rotator cuff surgery last year, and we had to pay the surgeon a month before surgery and the hospital required payment when I checked him in on the spot. We were notified in advance so we were expecting it. Vanderbilt hasn't asked for money yet, but I go Monday for my pre-surgery consult so they may ask for it then.

Share this post


Link to post
Share on other sites

Any surgery that is not done on an emergency basis is considered elective. ;) Just an FYI.

oh lol I didn't know that :rolleyes:

Share this post


Link to post
Share on other sites

I have insurance and they are asking for the co-pays that will cover my surgery and the pre-op testing (I have to pay one copay for each). However, the hospital is 'running a special' (who knew hospitals did that!?) and are giving me a discount on both fees. I have to pay both co-pays less the discount on the day of my pre-op testing because they don't want me to bring any valuables, including credit cards or cash on the day of surgery.

Share this post


Link to post
Share on other sites

I started this process a year ago and just got my insurance approval last week. Before they will even set up an appoint for me to get face-to-face with the surgeon and set a date, I had to pay my 30% and sign a contract with the hospital (and the check will have to clear!). Luckily, I knew going in that this would be expected and I am grateful that I was able to get a loan for my part, which is a little over $6,000.00. It's a lot, but I feel so lucky to have this opportunity.

And it's not that the surgeons are so standoff-ish -- they aren't. They come to support group meetings and do the info sessions and some preadmission testing (EGD). I think they just have to make sure the patients are as committed to this tool/lifestyle change as they are to helping us with it.

BTW, I'm new to posting, long-time lurker. Hoping to make lots of friends and join the loser's bench soon!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×