I am curious for those of you who have insurance to pay for this what the insurance companies actually paid once your surgery was done with according to eob's and what was considered reasonable charge and how much was above customary charges as a cash patient about 19 K procedure and that is only 1 night in the hospital.... I just wonder how much the insurance is actually paying...for me hospital is 11k, doc is 6500, anesthes 1500

My insurance covered everything but 700$ I have blue cross.

My insurance company covered everything but the $200- Hospital Admitting Fee, which my secondary insurance picked up....so besides the $500 program fee my Doctors office charges, my surgery was free. I'm very lucky as they paid for my lap band then paid for its removal AND the

Conversion to RNY.

Ok, I really didn't mean to brag there! I just consider muself very very fortunate.

My totals for everything was 42,000+...my insurance paid everything except for approximately 1200$. I applied for a hardship grant through the hospital because at the time I was a dislocated worker...and they approved it so my surgery and all of the trimmings end up costing me $0 out of pocket. The grant has even covered my office visits as well as my monthly b12 injections.... I am truly blessed. This surgery has been a blessing all the way across the board...

but I guess my question is how much does insurance pay the doctor how much is the hospital paid, I know you're covered by ins, maybe my question wasnt clear I'm just wondering if the doctors paid or how much actually being paid by the insurance company. the doctor can bill your insurance 20,000 dollars if you wants to and they can say no that's not reasonable we will pay you 8 and so the doctor is paid 8000. I'm interested in how much the doctor with Pay by the insurance company and how much the anesthesiologist was paid and what Hospital pay was.... just trying to see how much a insurance pays for someone to have the procedure verses what someone pays as cash patient. normally insurance companies write off about half of what is charged.... so I'm just curious

dfwtxfemme, I'm a cash pay patient also. If you don't mind does what your paying only cover what's involved that actually day of surgery and the one night at the hospital? My surgery is about the same as you 19600 but that covers initial consult, everything with surgery, 3 nights, 3 months post op visits, EDG, psyc eval. You should look into BLIS if your doc hasn't mentioned it yet, it is for cash paid bariatric patients. It like an insurance just in case you have any complication or have to go back to the hospital for some reason afterward you don't have to worry about having to pay more. It has different increments of time that you can be covered.

that is really good information thank you no 1 has mentioned that to me. it is a concern because you just never know... I just wonder how much more money the doctor makes off 1 cash payment then he does someone with insurance I know he have a higher price for cash man with the insurance companies pay but yes mine covers everything yours does. I like the surgeon charges 6500 for his part of it and you know if bills insurance company for 6k he might be paid 4000 and the rest is just written off as excess charges, I know the hospital fees insurance companies write off lots. the hospital bill my insurance 12500 for my kidney for a 2 hour morning day thing and my insurance pay them 2800 and said the rest of excess charges. so I know having cash patients pay 11,000 for the hospital for 1 night say a lot of that would be considered excess that we have to pay anyways because we are cash.... but I was just curious what actual insurance companies pay it and how much extra we actually pay because we are cash and none of it gets written off as excess and above reasonable charges...glad to know of blis, will definitely look that up and invest in that because you just don't know and I read on here people who go back in and stay for a week or 2 because of the leak or some other complications and that would be very pricey

I completely understand what you are saying. I always say that that was the only good thing about my insurance cause it seems like they don't cover much but it does lower the price on the original charges.

I understand your question, don't have an answer but I do know what you are wondering. I am pre op, but if someone who has had the surgery recently and has their bill they could probably read what was charged and what was actually accepted as payment from the insurance company. I would only think it fair that you get a break as a cash pay patient, but I guess that is my pie in the sky thinking.

I just had the surgery but I will give you more info once I start seeing what was paid and what had to be written off. I.know I'm responsible for 2300 for out of pocket.

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I don't have my itemized bill in front of me but here's what I recall:

Total bill: $41000

Blue Cross contracted rate: $11000

My portion : $2200 ( ins covers 80%, I pay 20%)

Fee paid to Surgeon $1200 from insurance

$ 240 from me

Hope this helps!

Yes thx doesnt matter i pay what it costs, just ridiculous that insurance is allowed to pay 1000 for the surgeon and I have to pay 6500, my 1 night stay in the hospital 11,000 that's ridiculous too I am sure insurance pays a lot less... I wish they charged cash patients what is that accepted from the insurance companies

I'm lucky I had met my deductible and my out of pocket max out so I have to pay nothing BCBS covering g @ 100% I am bless my surgery is tomorrow morning @ 6:00am.

I work in the Billing/patient financial services department if a hospital. Insurances set up contract rates with hospitals, that's why they only pay so much of the bill, it's why you pay for insurance. Our hospital works very will with cash patients. If you call the hospital and tell them you are paying cash, they will most likely give you a discount, we do 35%. You could also inquire about financial assistance, depending on your income, you could qualify for up to 100% bring written off. Just be sure to call then and ask for all of your options for payment.

the only problem is is the whole 19000 is paid to the doctor and he pays the hospital but they tell you the breakdown is 11,000 for the hospital 1200 anesthologist and 6500 to the surgeon.... again it's no big deal I mean its cost for cash patient I just know that it's a lot more than what the insurance companies contracted rates are for.... like the previous poster said her surgeon contract rate was 1200 dollars and I have to pay 6500 to him that the 500 percent markup.... it doesn't matter I was just curious as to what the markup was and clearly now I know.... I'm in the hospital for kidney and other things all the time I know how insurance work I just have a weight loss surgery exclusion which makes me a cash patient for it.... I know I my kidney surgery the anesthesiologist billed my insurance 1500 dollars and ins paid him him 300.... again up 500 percent markup but it doesn't matter I mean if I what the surgery I will pay 19,000.... seems all is said and done insurance get away with around 10 to 11K.... which is only twice as much but that's still a significant difference... I wish cash patients could just pay whatever it is the insurance companies pay