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

Unbelievable charge for VSG to my insurance



Recommended Posts

I received a statement from my doc's office last week and was completely unprepared for what I saw. My insurance was billed for a VSG and Haetal Hernia repair to the tune of $120,000! Holy ****! When I had asked how much the procedure was going to cost previous to the surgery I was told it would be around $25,000 in total and "not to worry" insurance would pick up the tab. When I contacted the billing department I asked how they could justify this sort of charge the associate said that this was a major surgery and the charge was normal. She also went on to say that just because $120,000 was charged it didn't mean my insurance would pay that amount. I replied that according to the statement the insurance paid the whole amount!!!!

Don't get me wrong. I had an awesome experience from beginning to end with my surgeon and his office staff, but was it all worth that much money? I think not. No wonder our insurance premiums are so much. To add insult to injury the docs office also said I had a balance of $2500 to pay out of pocket (after I was told there would be no out of pocket expense). I flat out told them to pack sand. No way am I paying a damn penny. They have had enough.

I appreciate that I am very lucky to have my insurance pay for this procedure. I just cannot believe the gaul of my doctors office to charge SO much! I wasn't even at the facility for 24 hours!

To give some perspective my boss had a tumor in his stomach and had the equivalent of a VSG with a FIVE DAY hospital stay. His bill in total came to $60,000. Can you see why I'm upset?

Share this post


Link to post
Share on other sites

that is ridiculous for surgery where you stayed just one day in the hospital...you are right that no wonder insurance premiums are so high...glad your surgery went well, though

Share this post


Link to post
Share on other sites

Seems quite high.

My Dr and hospital were seperate billings.

I've never seen ins companies pay the full amount of the charges.

Mine paid approx 1/2 of the charges but that amount was accepted as payment in full by the Dr & hospital.

Still my total charged by Dr and hospital for 1 night stay, sleeve & hernia was approx. 35,000.

This didn't include the anesthiologist or pathology which were billed seperately but also covered.

Share this post


Link to post
Share on other sites

I have two insurances, one through my employer and a second through my husband. Between both of them they paid the full amount.

Share this post


Link to post
Share on other sites

Quite normal. As usual, when you see this kind of distortion in the marketplace, you can bet that the government is involved - in this case, Medicare reimbursement practices are a major influence on this hokey accounting. "Normal" charges will be integral with your insurance contract with the providers (which, likewise, are not always the most rational things in the world, either.)

Share this post


Link to post
Share on other sites

I just received my EOB yesterday & for the sleeve, it was nearly $17,000 & my insurance paid all but $450. From most people I have heard their surgery was around the $20,000 mark. I can't believe yours was $120,000??!!! Wow....maybe they're planning on building a new wing onto the hospital!

Share this post


Link to post
Share on other sites

Mine was around $32,000 dollars and I had to pay $5,000 of that out-of-pocket, but I knew that was the deal going in. No matter what the "paperwork" says I can guarantee no one paid that much money. The hospital "discounts" the fee and the money changing hands is not that amount.

Your does seem like an astronomical number...since they are asking you for more money you might want to do a little bit of investigation about the bill. Good luck, I hope you don't have to pay more $$$$...

Share this post


Link to post
Share on other sites

... proof that our insurance 'system' is very broken...

Share this post


Link to post
Share on other sites

At self pay my total out of pocket was right at 15k. That's all the little bills and pre op qualifications etc. They still made money on me. That really shows how out if whack insurance is.

Share this post


Link to post
Share on other sites

That seems like a crazy amount to charge the insurance company. Did you ask the insurance companies why they paid so much?

Curious to know what the doctors office said when you told them you won't be paying the $2500...

Share this post


Link to post
Share on other sites

I received a "bill" yesterday...said I owe -7000.00...why send a bill when I know I owe nothing, paid cash. I looked at the total amount for the surgery, and even though my rate was pre-negotiated, it stated it was $42,000...that is WAY more than my cash price...I didn't know they could up the cost that much, they must do it to see what they can get insurances to pay. Although I didn't pull out my insurance card once, paid cash, no balance billing but I was still shocked at the price. You should really check that out, that seems like they shouldn't have billed both insurances, I'd ask them why they thought they should bill both.

Share this post


Link to post
Share on other sites

That seems like a crazy amount to charge the insurance company. Did you ask the insurance companies why they paid so much?

Curious to know what the doctors office said when you told them you won't be paying the $2500...

The person who writes off balances will be contacting me "soon". I will let you know what happens.

Share this post


Link to post
Share on other sites

My vsg surgery and 3 day hospital stay was over 250k and this does not include my surgeons fee. Crazy!

Share this post


Link to post
Share on other sites

My vsg surgery and 3 day hospital stay was over 250k and this does not include my surgeons fee. Crazy!

Omg that's a lot... Unbelievable

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

    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

      Tomorrow marks two weeks since surgery day and while I'm feeling remarkably well and going about just about every normal activity, I did wind up with a surface abscess on on of my incision sights and was put on an antibiotic that made me so impacted that it took me more than two hours to eliminate yesterday and scared the hell out of me. Now there's Miralax in all my beverages that aren't Smooth Move tea. I cannot experience that again. I shouldn't have to take Ativan to go to the lady's. I really looking forward to my body getting with the program again. 
      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 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

    ×