Community Chat

[Jordan2]

So I had cataract surgery on June 17 at a facility where all the eye surgeries are done for this large multi office eye centers. The doctor and surgery facility are both in network for my health insurance. The facility has my insurance information and knows what insurance I have. So guess what I got today, a bill from the anesthesiologist for $1,825! I don't know why I would get such a large bill. I will call my insurance company on Monday. Can they say the doctor was out of network? That shouldn't be my fault as the facility was aware of what insurance I had. Am I suppose to tell them, no I'll have the surgery without any anesthesia? I have heard this happening before, but I don't feel it is right. If I end up having to pay the whole thing, I'm going to pay it in many installments.

[nana59]

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@Jordan2 wrote:

So I had cataract surgery on June 17 at a facility where all the eye surgeries are done for this large multi office eye centers. The doctor and surgery facility are both in network for my health insurance. The facility has my insurance information and knows what insurance I have. So guess what I got today, a bill from the anesthesiologist for $1,825! I don't know why I would get such a large bill. I will call my insurance company on Monday. Can they say the doctor was out of network? That shouldn't be my fault as the facility was aware of what insurance I had. Am I suppose to tell them, no I'll have the surgery without any anesthesia? I have heard this happening before, but I don't feel it is right. If I end up having to pay the whole thing, I'm going to pay it in many installments.

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i'd pay it with rolled coins......i can help you out with that...my grandkids have been rolling coins...something to ease their boredom......

[Still Raining]

For me all my radiology md bills do come later, but they first bill the insurance.  Could that be the case?

[SunSprite]

@Jordan2   Does your statement show any insurance payment or contractual allowance? Or was $1825 the full charge amount? 

Given the quick turn around time (30 days) it's probably more likely that they didn't file your insurance at all. You probably just need to call the number on your statement on Monday.

[fthunt]

Question - so you were put 'under'?   Like:  out of it?

Thankfully I've had so few surgeries I may not understand your details correctly..  When I had both eyes done - I was wide awake and listening to doc and assistants gibber-jabber.  My eye(s) were 'frozen" but nothing more.

IF that's the way they do it now - guess the bill is legit so present it to your insurance company.  They may pay all or part of it.

[Texasmouse]

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@Jordan2 wrote:

So I had cataract surgery on June 17 at a facility where all the eye surgeries are done for this large multi office eye centers. The doctor and surgery facility are both in network for my health insurance. The facility has my insurance information and knows what insurance I have. So guess what I got today, a bill from the anesthesiologist for $1,825! I don't know why I would get such a large bill. I will call my insurance company on Monday. Can they say the doctor was out of network? That shouldn't be my fault as the facility was aware of what insurance I had. Am I suppose to tell them, no I'll have the surgery without any anesthesia? I have heard this happening before, but I don't feel it is right. If I end up having to pay the whole thing, I'm going to pay it in many installments.

@Jordan2  that happened to me when I had my cataract surgery as well as when I had surgery on my foot. I made sure the surgeon and the facility were in my network but on both occasions, I got billed for the anesthesiologist's services. When I called my insurance company (Aetna) I was told that anesthesiologists work like "freelance" and are usually not in network. 

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[suzyQ3]

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@Texasmouse wrote:

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@Jordan2 wrote:

So I had cataract surgery on June 17 at a facility where all the eye surgeries are done for this large multi office eye centers. The doctor and surgery facility are both in network for my health insurance. The facility has my insurance information and knows what insurance I have. So guess what I got today, a bill from the anesthesiologist for $1,825! I don't know why I would get such a large bill. I will call my insurance company on Monday. Can they say the doctor was out of network? That shouldn't be my fault as the facility was aware of what insurance I had. Am I suppose to tell them, no I'll have the surgery without any anesthesia? I have heard this happening before, but I don't feel it is right. If I end up having to pay the whole thing, I'm going to pay it in many installments.

@Jordan2  that happened to me when I had my cataract surgery as well as when I had surgery on my foot. I made sure the surgeon and the facility were in my network but on both occasions, I got billed for the anesthesiologist's services. When I called my insurance company (Aetna) I was told that anesthesiologists work like "freelance" and are usually not in network. 

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@Texasmouse, this is a common practice. It's just of a million things wrong with our health system.

[azgal]

First I would call the Doctor's office to see if they billed the insurance.

If they did, then I would call your insurance company for an explanation.

I had this happen to me and filed a dispute with my insurance company and they paid the bill.

Good luck. I hope it turns out to just be a mistake.

[Texasmouse]

@suzyQ3 there had been talk of implementing legislature to prevent "surprise" medical billing but I never heard whether or not it was ever passed. 

There should be transparency on these types of extra costs, discussed during the planning stages of a procedure.  It's not right to hit someone with a bill they never expected and didn't budget for, after the fact.

[SunSprite]

@Jordan2  Also, if they filed it to your insurance carrier you should have received an explanation of benefits; even if your carrier did not pay or denied it. The patient usually receives the eob before the provider recieves their payment. 

Did you receive anything in the mail from your insurance yet for this charge?