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It Literally Pays to Know Your Insurance

Sharon1964

By Sharon1964, in Insurance & Financing

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Sharon1964    2,530

Sharon1964
Posted

My surgeon requires a colonoscopy prior to gastric surgery if you're over age 50. I had mine in January. While I was under, they also did an endoscopy and took a biopsy of my stomach.

The colonoscopy is covered at zero copay to me, as it is one of the special screening procedures. I expected a small bill for the additional work for the endoscopy.

The hospital bill came in the mail. My insurance paid around $1500, and they said my part was around $1600, which was a combination of deductible and copay.

I called my insurance company and asked if the colonoscopy was indeed covered at 100%, and they said yes. So I said if I had only had the colonoscopy, my portion would be zero. How is it then, that adding a minor procedure that was performed while I was already in the operating room, already under anesthesia, caused my portion to go from zero to $1600??

The rep said he would attach the surgeon's bill to the hospital bill to show it was mostly a screening procedure, and send it back for review.

I got the result today in the mail. My insurance company paid the $1600 they originally said was my portion, bringing my portion to... ZERO!

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ProudGrammy    8,322

ProudGrammy
Posted (edited)

insurance paid $1,600.00 - my portion to... ZERO!

@@Sharon1964

take a bow bud :)

you questioned the insurance company

moved ahead with your phone calls

discussions about the procedures

talking to a rep

waited for a written response........

mail finally arrived.....

you didn't owe a penny!!! :)

how great is that - and you too!!

I always hand the phone to hubby

he doesn't mind dealing with the ins co

while i deal with my frustrations :mellow:

hubby is willing to put up with the insurance company

and with me too!!!! :D

hubby is VERY smart

he married me didn't he!! :D :D

congrats on starting your new healthier, happier, longer life

who deserves it more :)

good luck with surgery

kathy

Edited by proudgrammy

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mykdzmom    388

mykdzmom
Posted

I am glad you questioned them. I have more time than money myself, and it never hurts to ask. Way to go!

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Go To Topic Listing Insurance & Financing

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