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YIKES! Weight Loss Surgery bill came today!



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$10,000 in Las Vegas, one day surgery owned by the Surgeon. Pay cash up front and you are done.... No trip to Mexico no hospital stay, no bills.

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I'm getting sleeved on Dec 17th and the total surgery expense including three day hospital stay would cost me approx 3500 USD. Unfortunately. we do not have insurance for bariatric in India.

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My insurance would only pay 50% but my out of pocket max was 4500. Since it iz the end of the year I only had to pay 1000 after all tests and other appointments.

Also my insurance will only pay a maximum of 10,000.

I asked several times how this was going to work since I paid my out of pocket maximum. Guess I will see in a couple of months!

The insurance will require your hospital to write the remaining amount off stating that you have hit your OOP max and that the remainder cannot be billed to you.

However, they might bill the surgery and the hospital stay separately so as to get more money from the insurance company. Mine did. The hospital stay/recovery room and all that was one billing and the actual surgery was another one. So I got two EOBs from Blue Cross for the same procedure.

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Most surgeons bill separately from the hospital unless your surgeon is an "employee" of the hospital. My surgeon has a private practice and that bill will always be separate, they are two different entities. If you have met your out of pocket max that doesn't mean the hospital has to write the balance off....it means that your insurance should pay the balance of the allowed amount, if they participate with your insurance. If they don't participate with your insurance the hospital and surgeon can bill whatever they want. They have no agreement as to what they will accept. That's why whenever you possibly can you should see an in network provider and go to an in network hospital. I work for several surgeons as a medical biller we are a private practice and we bill our surgeons fees separately from the hospital.

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landerr, on 22 Nov 2014 - 15:59, said:

Wow that's cheap, I was sleeved on Monday and already got a bill, $93,345. Only 1 night in hospital and no complications, glad I have good insurance.

You got scammed. There's no way in the word that a VSG would cost that much and especially since you only spent one day in the hospital. In my state it's about $16,000, self pay. The average seems to be $25-$30,000.

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oooops



sorry, didn't mean to post here


:( :( :(



kathy

Edited by proudgrammy

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You got scammed. There's no way in the word that a VSG would cost that much and especially since you only spent one day in the hospital. In my state it's about $16,000, self pay. The average seems to be $25-$30,000.

Sweetheart I don't know where you live but it's clearly not a major metropolitan city like la, nyc etc. Because you would keel over from a heart attack if you saw the charges around here. I am in north jersey

Nyc is notorious for large charges

It costs money to get sick

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My insurance would only pay 50% but my out of pocket max was 4500. Since it iz the end of the year I only had to pay 1000 after all tests and other appointments.

Also my insurance will only pay a maximum of 10,000.

I asked several times how this was going to work since I paid my out of pocket maximum. Guess I will see in a couple of months!

So you better call your carrier and talk to someone who understand your benefit clearly. I work in insurance and the way you have stated it is

You have a maximum benefit of &10,000

You saw an in network doc and hospital.

Your benefit is $10,000

That means if the contracted rate is $14,00 for hospital and $5,000 for the doc

Hospital will get $10,000 and you pay the difference

You will pay the surgeon in full

A maximum benefit is just that a max payable amount. The hospital and surgeon are not required to write it off if your max benefit doesn't reach the contractual limit.

You have a really shitty plan. Sorry

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Quote

Jersrose43, on 26 Nov 2014 - 08:37, said:

Sweetheart I don't know where you live but it's clearly not a major metropolitan city like la, nyc etc. Because you would keel over from a heart attack if you saw the charges around here. I am in north jersey

Nyc is notorious for large charges

It costs money to get sick

The average price of a VSG in NY is $23,000. And I've found a post on another board from a woman who claimed her VSG in NYC cost $30,000.

The average price for VSG in California is $17,000. I've found posts from people on other boards who claimed they paid $20-$30,000 for their VSG in LA.

Having a VSG in a major metropolitan city only slightly raises the price. You are the first person that I've ever come across who claimed it cost them nearly a 100 grand for their VSG. VSG is not a difficult surgery and an experienced surgeon can accomplish it in 30-45 minutes. In some place, especially in Mexico, they have VSG mills where they churn out large numbers of patients a day because the surgery is rather easy.

To see the average rate per state, click on the link below and then click on the image.

http://obesitycoverage.com/insurance-and-costs/how-much/average-cost-of-gastric-sleeve-surgery

Edited by Proud2BMe

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I think you missed the nuance dear. She didn't pay that. You're quotes are cash prices

The CHARGES are extensively higher.

I am in north jersey and hospital was $41,000. Insurance paid $17

Surgeon was $21,000. Insurance paid $5 and change

Anesthesia was $3800 and insurance paid in full.

It is not outrageous to expect a bill to be $100 k or more here.

Mine was overnight but still outpatient so 23 hours. If I had been inpatient then extensively higher

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@@Jersrose43

I didn't miss the nuances. I know how to read and you clearly wrote that you had good insurance.

One of my online friends had insurance and was sleeved in NY but most likely not NYC. The price was $37,0000.

Just so you know, there are doctors who do purposefully overcharge insurance companies. This is one of the reasons why insurance rates went through the roof pre-Obamacare.

Edited by Proud2BMe

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I was self pay. Once I selected a Doctor I was able to shop around. If I picked a hospital that was older and more urban I could save about $4000 over the nice new one by my house. The anesthesiologist knocked $430 off the bill if I paid in advance. If I paid the hospital up front ($9000) they would cover the surgery, pre and post op and 72 hours of care. My Doctor also had a pay up front discount. I did the whole thing for $14,055.00.

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@@Jersrose43

I didn't miss the nuances. I know how to read and you clearly wrote that you had good insurance.

One of my online friends had insurance and was sleeved in NY but most likely not NYC. The price was $37,0000.

Just so you know, there are doctors who do purposefully overcharge insurance companies. This is one of the reasons why insurance rates went through the roof pre-Obamacare.

And that's why you go to a contracted provider. You can "overcharge" all you like but are only responsible for contractual allowances.

I have a &4500 deductible and additional $4500 out of pocket.

And I work at my insurance company.

Smile. We don't get it for free

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And this year will pay just short of 2500 In premiums

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You got scammed. There's no way in the word that a VSG would cost that much and especially since you only spent one day in the hospital. In my state it's about $16,000, self pay. The average seems to be $25-$30,000.

Proud2BMe, that is what my doctor and hospital charged me, I went to Geisinger Hospital, $13,000 doctor fees and $80,000 hospital fees. I really don't care what they charged since my employer covers bariatric surgery and I only owed $200 for the entire bill.

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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
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