JESUS H. CHRIST! I had "day surgery" on December 21st.

[rzemanfl]

I arrived at 7:30 a.m., sat around for a half an hour in the lobby, then laid there in a semi-stupor on an IV until 10:30 when I finally went in for the surgery, they hustled me out the door at around 3:00 in the afternoon. This place is not a hospital, they only do same day surgery and discharge people to someone who will drive them home. The bill, not counting the doctor or the anesthetist, was TWENTY-FOUR THOUSAND SEVEN HUNDRED SIXTY-NINE DOLLARS! My insurance paid them $4,564.07 and says I owe $1,141.02. They told me I had no co-pay to make the day I went in. What kind of a joke is it to charge $3,500.00 an hour to lay on a fucking cot?

[Cleita]

1. I would look into it. Usually when a clinic accepts an insurance

assignment, it means that they agree to accept what the insurance will pay, usually 80% of the whole bill. You may not be liable to pay for that extra 20Gs and only the $1,141.02.

[rzemanfl]

6. All I owe is the $1,141.02, but my insurance company is trying to

charge it to this year's out-of-pocket maximum, not last year's like they should be.

[jody]

11. Pardon the intrusion on another branch but when does the fiscal year for your policy begin? n/t

[rzemanfl]

13. Calendar year. n/t

[jody]

14. Thanks. You really do need to set down with the person in accounts and make sure everything is OK.

Good luck in getting your problem resolved. :hi:

[madrchsod]

2. surgical centers are a rip off

we`ve had several around here but they went bankrupt..but i had excellent care and no staph like i got at my regular hospital...

[rzemanfl]

9. I've had surgery done outside a hospital twice in the past and

was not the victim of this sort of attempted rape either time.

[jody]

3. Did you know in advance what your procedure would cost? n/t

[rzemanfl]

8. They told me before the surgery I had no co-payment to make.

I took them at their word.

[jody]

10. Please check on the billing, clerks do make mistakes. n/t

[MercutioATC]

15. It's possible to have no "co-pay", but have insurance that only pays part of the cost

...either as a maximum benefit or a lower percentage than 80%.

[Warpy]

4. If you didn't have insurance, your bill would have been

at least twelve thousand dollars with the magnanimous "discount" they're now giving us to make us feel like we're really getting a deal. Nobody pays that $24,000.

Ask for an itemized bill for the additional charges. Often insurance companies will pass on charges for things their computer models tell them you didn't need for that particular procedure. The hospital then passes the charges on to you. This is one way they make more money.

Once you have the itemized bill, you can start fighting the insurance company by submitting it, making sure that none of it was for things like a pregnancy test on a male patient. If any of your friends are nurses or doctors, they can help you with this part.

Once the hospital knows you are going to fight, they will generally lower the bill to save themselves time and trouble.

Once the insurance company knows you are going to fight, they will often offer to pay part of the surcharge.

Your last line of defense will be to contact the consumer affairs ombudsman at your state's Attorney General's office.

[tabatha]

5. I had day surgery about 10 years ago

and the bill was $10,000. I had to fight to get the bill paid because I had to go outside of my HMO to get emergency surgery. I eventually won. I am glad I don't have to have that surgery today.

[wtmusic]

7. Typical.

The cost for outpatient "surgery suites" is outrageous (mine cost $28K last year). Of course the amount is never paid, but damned if they don't try for it anyway.

[Kittycat]

12. Contact your insurance company and appeal.

If you don't owe the copay, it sounds like those are charges that exceed "reasonable and customary". I just went through this with my son, and insurance just paid the balance. If you let it ride, you'll be stuck with it though - so it's best to act fast.