Okay- I have BCBS PPO (Network Blue) here in Florida. I had my surgery on 7/5/11. Prior to surgery I called and checked my benefits and was told that VSG is covered with a 10% copay since I had already met my deductible. The surgeon's office made a copy of my insurance card and verified my benefits, and informed me that my co-pay would be $150, which had to be paid up front.....

Well, out of the blue I get a call from my surgeon's office today saying they got notice from my insurance that I am responsible for $1340-WHAT?! So, I contacted insurance and they are blaming the surgeon's office saying that whoever verified the insurance made a mistake and that my surgeon is out of network. The surgeon's office is blaming BCBS saying that they were told my copay was only going to be 10%( which was the $150 I already paid)....either way, it looks like I am going to be left with a bill that is TEN TIMES the amount I was quoted

What do you guys think? How can this be right?! It's like going to a restaurant and getting the menu that quotes your meal as $10, then after you have eaten it, they say "Oops, it really costs $100" Unbelievable!!!!

What would you do???????????

Insurance sucks!

Your surgeon's office biller can apply your insurance company if everything is documentated like they say they verified. It's illegal to transfer any balalnce down to the patient unless the remit from the insurance company states so. You can request a copy of your medical remit for you surgery and see what was covered and what wasn't covered. It's your surgeons billers responsibility to bill out correctly. And if they are out of network they can appeal the insurance company for medical ness. and maybe win the cost. I am a medical biller for dialysis and I deal with this things all the time.