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Deductible



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My drs office told me today that I have to finish paying my deductible, AND pay the up front drs charge. This vill be over $4,000 for me. This has to be paid before my surgery. Is this a common thing?

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I had to pay the doctor up front also. I paid the hospital on the day of surgery. I don't know if it makes a difference, but I was self pay.

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I believe the deductible has to be paid before the surgery is done. As far as the drs fee I'm not too sure. But $4000 is a bit pricey. What kind of insurance do you have?

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I have Cigna. I knew about paying the dr. up front, but not that I would have to pay out my deductible before surgery.

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I got a big estimate/Bill like 2 days before surgery showing what my put of pocket cost would be..I thought at first I was going to be expected to come up with it to have the surgery. It showed like $3300. When I called a little freaked out, I was told I could make my payment to my dr office which I had been told from the beginning would be around $550. After that, the rest I can set up a payment plan. Maybe they would be able to set up a payment plan for you?

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I was told I have to pay my surgeon's office 3 days before surgery and the hospital the day off. My surgeon's fees are $495 and the hospital is $1500. It could be lower since I have had a few doctor's appointments since I was told the number.

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oh the complicated joys of insurance billing. I feel your pain. I am just going to roll with the punches.... I know my catastrophic annual limit is $6000. I know it will not be over that. thru the year I have already paid over $1000.

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I have to pay whatever is left on my deductible and out of pocket prior to surgery.

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I guess I am a real naïve dummy when it comes to insurance and deductibles and all that. Three days before my EGD was scheduled I get a call from the surgery/procedure scheduler and she told me I have only paid 183 dollars on my deductible. I have a 2000$ deductible, max out of pocket. is 6000$. She said I had to at least pay 500 up front before EGD could be done, then the insurance would start paying 60%, so of course I didn't just have 500 laying around, so that's been delayed, then the insurance/billing person told me that 10 days before my surgery date which has already been scheduled but I can't do it til the EGD is done, she would call me and let me know what I would have to pay up front for my surgeon's fee, she couldn't give me a dollar amount as she said I haven't paid the 500 yet so she wouldn't know how much til I do that, and that there would also be a person calling me from the surgery floor telling me what I have to pay up front for the "facility fee", she couldn't tell me how much that was either. Then what ever is left to pay I could make payments on. So can someone explain this to me in terms I can understand, I don't want to get a loan for 500 then turn around and need more money after that. I am having my surgery done at Shawnee Mission Health at Prairie Star in Lenexa KS. Dr. Hoehn is my surgeon thru the Bariatric Center of Kansas City. Any advice or input would be greatly appreciated. I am someone that lives paycheck to paycheck, just put my youngest in college and have one in last year of law school. so I don't have a nest egg lying around, I just wish I knew what to expect. Thanks.

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I have humana platinum and I have to pay $250 for the nutritionist. I have. A $1000 deductible which will start after my surgery.

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There is a good article at http://healthinsurance.about.com/od/healthinsurancebasics/a/Out-of-pocket-Maximum-how-It-Works-And-Why-To-Beware.htm. I hope this helps some. There can be so many variables.

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Unfortunately it is becoming more and more common for healthcare providers to collect deductible payments up front, especially in cases of large deductibles. This change is because medical bills have a pretty high rate of non payment and collection costs even though the doctor provided the services in good faith. Combine that with the fact more and more employers are switching to high deductible health plans, medical providers are spending steadily increasing amounts of time and resources collecting payments from patients. Collecting payments from insurers is easier and more reliable than collecting from patients. On the other side of the coin, families don't always have much of a choice as to which health plan they have. They also don't always have the resources to pay what their health plan doesn't cover. It is a double edged sword and it hurts both the patients and the providers.

Unfortunately, there also isn't much that can be done about it but pay the amount you are responsible for. I don't know if this helps you much, but I will tell you how I prepared for the large cost. I have been making a weekly automatic payment to my surgeons office starting the first appointment and all the way through my pre-op preparation appointments. I have sent $30 every week and it has really made a huge dent in my amount due without being a shockingly large bill right before my surgery. It is definitely worth asking the providers if it possible to set up a payment plan for the balance due. They may look more favorably on a payment plan if you start a weekly payment every week right now and show them your intentions are good and you are reliable. My provider did offer to continue my current payments after surgery until the balance is paid in full because I took the initiative to start pre paying my portion. Unfortunately, there is no easy way around this.

What was your plan to pay your deductible and any other balance due after surgery? Can you implement the plan sooner? Can you keep the same plan and start it when you planned to but just put your surgery off until a good portion of the balance has been paid? I know delaying surgery is nobody's ideal situation and is disappointing, but I don't know if you can find a way around it. There are very few providers and/ or hospitals that will balance bill patients with large deductibles or out of pocket expenses this day in age.

Hugs and support to you because that policy should have been discussed with you before you got this far in the process. We are all here for you if you need a shoulder to cry on or someone to help you find a plan that works for you.

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I have a max out of pocket of 3750.00 mine is paid for so my surgery is free....i paid 3750.00 starting from jan 1st until now and so my surgery is 100% covered...good luck to you

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Jhood2005- I am also having my surgery with kc bariatrics. I know that initially they told me until my deductible was met they wouldn't be able to tell me what the co-insurance would be. I don't think ins will give them the allowed amounts, etc until the ded has been met. Unfortunately or fortunately depending on how you look at it, my husband and daughter both had some hospital stays and now I have met all the ded/coinsurance. I do still have to pay the $250 program fee before they can submit to ins for approval. I have an appt mon, egd the following week and then the class and 1 more visit in oct so I guess I better figure that into my budget somewhere! Good luck to you!!

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