Hi All,

I had my sleeve performed by a well known and respectable North Texas Clinic in June 2017. I am loving how I feel etc, and have got to my goal weight. Operation was 16 Months ago. Yesterday I received an invoice for $1782.78 for co-insurance from my anesthesiologist ( the total for 2 Anesthesiologists was $17k) I believe they were out of Network. I wouldn't mind, the surgeon only billed $3K. And why 2 Anesthesiologists when It was routine, no known prior or during issues and I was in and out in 45 minutes. I believe the Anesthesiologists were out of network. But I was not told any of this and it just doesn't seem right that 16 months on I am receiving a first invoice for such a huge amount. The co insurance I owe on 1 Anesthesiologists is $82 the other is $1,700. What advice do you have people? I don't understand insurance etc. and any advice on how to deal with this would really help.

Thanks

Paul

2 hours ago, Paultexas said:

Hi All,

I had my sleeve performed by a well known and respectable North Texas Clinic in June 2017. I am loving how I feel etc, and have got to my goal weight. Operation was 16 Months ago. Yesterday I received an invoice for $1782.78 for co-insurance from my anesthesiologist ( the total for 2 Anesthesiologists was $17k) I believe they were out of Network. I wouldn't mind, the surgeon only billed $3K. And why 2 Anesthesiologists when It was routine, no known prior or during issues and I was in and out in 45 minutes. I believe the Anesthesiologists were out of network. But I was not told any of this and it just doesn't seem right that 16 months on I am receiving a first invoice for such a huge amount. The co insurance I owe on 1 Anesthesiologists is $82 the other is $1,700. What advice do you have people? I don't understand insurance etc. and any advice on how to deal with this would really help.

Thanks

Paul

Never just accept a bill if you feel it's wrong, I had an incident where I ended up in the ER for almost 9 hours for gallstone pain, the doctor on duty tried to charge me for 9 hours of his time... even though I only saw him for 5 mins, everything else was done by the nursing staff. I fought it, BCBS investigated and that doctor charged all the beds for the same time... and that ER had like, 20 beds, so this dude was trying to defraud the insurance company for hundreds of thousands of dollars, a night. So, if it looks off, it very well could be, appeal it, ask for documentation to prove 2 were there, and why and the actual work performed, you have ever right to find out exactly what and why was billed for your surgery, sometimes you just need to keep pushing back until it gets dealt with.

Do you have an EOB (explanation of benefits) from the insurance on this - that is their take on the situation, and on what you are obligated to pay (in their view)? It sounds like the insurance is paying for the first anesthesiologist, but (correctly) not for the second.

Call their billing service as the first step, and ask what is going on. Then you can also take it up with your surgeon, as he is the one who usually specifies what anesthesiologist he works with, and any problems here reflects upon him (or her).

My wife had some spinal surgery a couple of years ago, half a day's worth in the OR, and we got a bill from an OR nurse asking for over $16k, of which the insurance paid around $300. Unresponsive billing service, so we asked the surgeon about her and he made a quick text to the nurse and we had a call from the billing service removing the obligation by the time we got home. Unhappy surgeon is not nice on the hired help!

This happened to me when I had surgery for something in my early 20’s. Your surgery was planned and the doctors/team should have planned for anesthesiologists in your network.

Mid they legit had no anesthesiologists in the hospital or center you went to then you can now ask for the anesthesiologists to get under the network you are in; or you can call the hospital and tell them it isn’t your fault that the docs were out of network and you want to fight the bill. Or you can simply pay it if you choose to; most hospitals have payment plans.

in my case, the anesthesiologists/his practice filed to be put within my network/under my insurance and all was well. Don’t know if this happens often but it doesn’t hurt to call or ask.

This happened to me with sinus surgery. It was a long time ago and I don’t recall all the details but I remember I didn’t have to pay. You can take it up with your insurance and the anesthesiologist practice both. There’s no way to know they’re out of network.