Excelle

Having had to undergo medical procedures the last two years, I had run across the following issues.

When I pre-certify do all my pre-op work I always ask the hospital intake individual the same questions    1) Beyond my co pay and deductible what will I owe.  The last surgery I made a point of asking Mrs. Intake, I have a 150.00 deductible/co-pay the insurance only pays 80% what is the balance for this procedure?  She kept saying $100.00.  So I rephrased the question. That's incorrect, Mrs. Intake y co-pay deductible is  $150.00 so I owe at least that much.  How much is the procedure so that I can pay the 20% that insurance does NOT cover.  She still insisted I owed only $100.00.  BY now I was more than frustrated and asked to speak with her supervisor.  I got the same answer.  I went at head and put $1000.00 against the account. Surgery was the following morning.  CAN YOU IMAGINE MY SHOCK when I received a bill for an additional $4,500.00!!  I was livid. I called the hospital and asked for Mrs. Intake and her supervisor.  I asked for an explanation and reminded them that I asked point blank at least three times only to be told my part would only be $100.00.  They just could not understand why I was upset. I asked it the cost of the procedure went up $5000.00 between four o'clock Wednesday afternoon and 5:30 Thursday morning.  There were no complications, no extra procedures. I told them I felt like I had been deliberately lied to. Had I any indication that the balance for this procedure had been this  much the procedure would have been delayed until I had enough in reserve to pay it.  This is a deceptive and dishonest business practice!  When is there going to be some sort of regulation to hold businesses accountable when they say this is the cost and your portion is....

Is there any other business that can stay in business doing this?  If the daycare you take your child to tells you the cost is $160.00 per week for their service and at the end of that week they had you a bill for  $500.00 , if you go to the grocery store and add your items as you go and it totals  $237.25 (you already know tax will be added) but imagine if they total the items and hand you a bill for $750.00! Everyone knows they have already contacted your insurance company to verify your coverage and co pays, they know the billing for the procedure so WHY can't they be honest about the amount not covered by insurance.  They don't know .... please, I checked a friend in for surgery two weeks ago.  The first thing Ms Intake did after having her sign everything was tell her they needed a $1600.00 for what the insurance didn't cover.  Why was I denied this?  Shouldn't we all be allowed to decide if we can afford the procedures we are being asked to endure and pay for?

This is an issue in the medical field all over.  I've found that the best way to find the cost of any procedure is to discuss it with the insurance company first.  Of course, you'll have to work hand-in-hand with the particular hospital/doctor/dentist you choose to go to, but by discussing it with both will help to eliminate some of the shock of the bill.  Hospitals tend to charge for every little thing and there is no way that an insurance company will be able to tell you the entire cost; a simple aspirin could cost you hundreds of dollars.  However, we'd at least have an idea of the cost of the procedure.

We, as consumers, are often caught up in a catch-22.  I, too, have often had extra costs because insurance companies only pay so much and the average hospital/office has charges over and beyond what the insurance pays.  I even had insurance that stated that I was not to be responsible for the charges because they were over and beyond the customary charges; however, the hospital still charged me for them.  Be careful of signing anything that says you are responsible for what the insurance does not pay - which is how they get us.