I received my Explanation of Benefits in the mail today from Kaiser Permanente. It tells me what was billed by the hospital and doctors, what was disallowed, and what was allowed and paid. This was for my lap band to sleeve revision, and I spent two nights in the hospital.

For my surgeon:

Charged: $13,750 Disallowed: $10,350 Allowed and paid $3400

For my hospital stay:

Charged: $80,231.28 Disallowed: $75,843.28 Allowed and paid $14,388.00

And so the total amount that Kaiser paid was $17,788.

I didn't even have a co-pay, and the member responsibility was $0. I feel so blessed to have Kaiser Insurance. Now, we do pay out of pocket for our health insurance, and our premiums come to about $12,000 a year, but it is great insurance to have.

I paid cash to have my lap band put in at a surgery center in 2008, and that came to about $14,500.

I just thought somebody might find this interesting. It just shows how our whole medical system is screwed up in this country. If my insurance hadn't paid for this, I would have gone to Mexico like many have done.

I totally agree with you. Medical billing in this country is a big joke and sickens me.

I am still dealing with my medical bills for my surgery in late December 2011, which was pre-authorized. It's funny that for my sleeve, insurance was billed about $10,000 per day for the hospital stay, and that is what insurance paid. Everyone else got a fraction of the billed amount.

For my husband's back surgery just two years ago, the billed amounts exceeded $250,000 and everyone received a fraction.

And it is a complete wildcard what the uninsured would ever pay. Maybe they should just never walk again? It's terrible.

Well, I didn't go to Mexico.... unfortunately... and was a self pay. What you've described is applicable to one of my two bills for my complications that I had after my surgery. And my insurance is not helping (I had a stink arse plan, 15 k max benefit as I work as a contractor after getting laid off in 2/2011).

IDK what I'm going to do to pay this off. And I'm rather scared & freaking out. I hope that whenever I call the financial assistance personnel on Monday that God blesses me with some better news than I am currently bracing myself for.

But I'm glad yours got paid. Congrats.

Well, I didn't go to Mexico.... unfortunately... and was a self pay. What you've described is applicable to one of my two bills for my complications that I had after my surgery. And my insurance is not helping (I had a stink arse plan, 15 k max benefit as I work as a contractor after getting laid off in 2/2011).

IDK what I'm going to do to pay this off. And I'm rather scared & freaking out. I hope that whenever I call the financial assistance personnel on Monday that God blesses me with some better news than I am currently bracing myself for.

But I'm glad yours got paid. Congrats.

OMG...surely, they don't expect you to pay full price...I would ask for the insurance rate. I had to pay for a hysterectomy several years ago, $14,000.00. Once I paid a couple of thousand, they wrote off 1/2 my bill...it was like a one-time offer. They would have to be insane to think that someone could pay that bill off, and I don't know why the insurance company only has to pay around 14,000.00 for hospital and surgery, probably less than that, and they expect a self-paying person to pay the full price. I will have to look at my bill and let you know what insurance actually paid.

My insurance actually paid 5,739.82 for the hospital, surgeon, and anesthesiologist. My portion was around 800.00.

Kiki, pls pray for me. I WISH I could get a deal like that. The first bill is now at 10K (I just sent in 325 and some change). The next one, they charged 90K and 70K is ineligible per the insurance bill, but that leaves 14k on the second bill. Mind you I've already paid for this surgery (my first one) and am already out of that money.

IDK what I'm going to do... breathe and remain calm. And either pray that the cars don't break down (we both need new ones to be honest) or just pray that something works out. Since I'm a contractor - not to mention in this economy - I'm freaking out to be honest. Today I'm much calmer, but scared to be honest.

I'm just putting all of my b'ness out there now too, I hafta be nuts.

Thanks for your input tho too Kiki....

That's terrible, 4A. I would definitely go to the billing department and tell them that you can't possibly pay that $14K and ask them what they can do about that. When I was younger and didn't have health insurance, I had a hospital bill for an emergency room visit and a one-night stay that I couldn't possibly pay. They were jerks and wouldn't reduce their price, but they couldn't damage my credit rating or send it to collections as long as I paid something every month. I ended up paying them $50 a month for five years. Good luck to you. You may even want to get a free consultation from an attorney if you can find that.

My claims have just come in for my surgery here in Milwaukee, WI. $48,458 was the total paid by my insurance. I would be responsible for 10% of that, but I have an out of pocket maximum of $1800. Some of that has already been filled by me so my portion will end somewhere around 2% of that total. It is outrageous how much these hospitals charge the insurance companies. My surgeon and anesthesiologist each charged $4,500. I had a few specialists reading test results that were each about $500. The hospital charged $35,000. That being said, I will say that I was treated like royalty there and I did have heart complications during my stay. I was still only there 2 nights though!

Just another chuckle: I received the Explanation of Benefits for my anesthesia today. The topic should read that my surgery bill was $96,861.28 because my Anesthesiologist billed $2880.00 for me of which $1945.08 was disallowed and $934.92 was paid, making the actual amount paid for my surgery a grand total of $18,722.92. Thank you to Kaiser Permanente!