Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Getting money back from surgery



Recommended Posts

So i had my surgery last month. I am self pay as insurance will not cover. I paid around $18-19K. I had to pay before i could have the surgery. A couple weeks after surgery i notice there was a claim from the hospital on my insurance for that same surgery for around $40K. Which they denied since its not covered. I called the hospital to find out what the heck is going on. So i gave them my receipts showing i paid the Surgeons fee, Surgeon assistant fee, Anesthesiologist fee, Hospital facility fee, complication coverage fee, Pathology, psychological exam, and nutritional evaluation. all coming out to about $19K. So they told me they would figure out what happened and why my they did my insurance instead of self pay. Today i get a email from the hospital that they switched me to self pay and that i am owed a refund of over $3,000 which was odd because i am not owed anything. So i called and they checked and checked and said they gave me a discount since I paid cash lol. So i was like... ARE YOU SURE... Because once i get this money i am paying off my credit cards and you wont be getting that money back... and they checked and said i am good. So i should be getting some moolah back here in the next couple days lol. So thanks for that mistake haha.

Share this post


Link to post
Share on other sites

Oh wow what a stroke of luck! Maybe they charge less for self-funding patients? No idea how things work in the US. :)

Share this post


Link to post
Share on other sites

27 minutes ago, Spinoza said:

Oh wow what a stroke of luck! Maybe they charge less for self-funding patients? No idea how things work in the US. :)

So for self pay patients we get a self pay rate. The money must be paid before surgery. which i paid everything on this list. To me its a mistake that they are refunded. but they said they checked and the phone call to the hospital was recorded and they have it in their notes so if something comes up later its not my problem lol.

selfpay.png

Share this post


Link to post
Share on other sites

They do often give discounts for self pay, robbery that they bill insurance 40k but less than 20k if not…

Share this post


Link to post
Share on other sites

Well at least if they do come back and ask for it you can make small payments and take your time paying it cause there is no interest. I once paid a medical bill off at like $15 a month. I talked to the girl in billing and told her I was going through tough times financially and she said as long as I sent something she didn’t care how much it was.

Share this post


Link to post
Share on other sites

2 hours ago, ShoppGirl said:

Well at least if they do come back and ask for it you can make small payments and take your time paying it cause there is no interest. I once paid a medical bill off at like $15 a month. I talked to the girl in billing and told her I was going through tough times financially and she said as long as I sent something she didn’t care how much it was.

Yea thats with any bill to keep it from collections pay something. Even 5 bucks lol. I use to be a debt collector and we had people do that all the time to keep it from going onto their credit. They would mail in a 5 dollar check every month. remember one guy sending a dollar (he could afford more but didnt want to pay it lol)

Share this post


Link to post
Share on other sites

6 minutes ago, liveaboard15 said:

Yea thats with any bill to keep it from collections pay something. Even 5 bucks lol. I use to be a debt collector and we had people do that all the time to keep it from going onto their credit. They would mail in a 5 dollar check every month. remember one guy sending a dollar (he could afford more but didnt want to pay it lol)

OMG, a dollar. Nowadays it wouldn’t be worth it to cover the check and the stamp. Lol

Share this post


Link to post
Share on other sites

15 hours ago, Spinoza said:

Oh wow what a stroke of luck! Maybe they charge less for self-funding patients? No idea how things work in the US. :)

they often charge insurance companies way more than they charge self-pays. My plastic surgery was self-pay. I originally got a statement that my surgery (which I'd already paid for) was like three times more than what i paid for it. When I called, they said it was just a statement and to ignore it since I'd already paid. I'm pretty sure that was the amount that would have been billed to the insurance company if insurance would have covered it.

Share this post


Link to post
Share on other sites

I do insurance billing and the fees we charge when we bill to insurance are pretty arbitrary.

In my specialty, Medicare used to pay us based on groups. So group 1 codes would be allowed $400, but group 2 would pay $800. Instead of having a different charge amount for every procedure, we took the highest paying group and round it up to the next $100. At the time that the fees were entered (2004), we charged around $1000. Then work comp changed their manual and allowed at $1593 for one procedure, so all of our charges became $1600. The fees haven't changed since.

If we add a new procedure to our services, we take the current MCR fee schedule and times it by 2.4 to get our charge rate. We do this because 90% of our commercial health insurance plans are based on a percentage of Medicare allowed. Our highest is 200% of MCR.

Share this post


Link to post
Share on other sites

So i got an email this morning... Saying that the 3K refund was a mistake. That they would correct it... GO FIGURE... lmao

Share this post


Link to post
Share on other sites

19 minutes ago, liveaboard15 said:

So i got an email this morning... Saying that the 3K refund was a mistake. That they would correct it... GO FIGURE... lmao

When it seems too good to be true, it usually is...

Share this post


Link to post
Share on other sites

1 minute ago, kcuster83 said:

When it seems too good to be true, it usually is...

SOOOO DAMN TRUE LMAO

Share this post


Link to post
Share on other sites

47 minutes ago, liveaboard15 said:

So i got an email this morning... Saying that the 3K refund was a mistake. That they would correct it... GO FIGURE... lmao

Darn it. I had a sneaking suspicion that would happen.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

      Tomorrow marks two weeks since surgery day and while I'm feeling remarkably well and going about just about every normal activity, I did wind up with a surface abscess on on of my incision sights and was put on an antibiotic that made me so impacted that it took me more than two hours to eliminate yesterday and scared the hell out of me. Now there's Miralax in all my beverages that aren't Smooth Move tea. I cannot experience that again. I shouldn't have to take Ativan to go to the lady's. I really looking forward to my body getting with the program again. 
      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×