Guest guest Posted April 22, 2002 Report Share Posted April 22, 2002 Your bill from was $24,000?????? It was my understanding that the $17,000 that Dr. R was " charging " was an all-inclusive price - meaning no bill from anyone else. That is what I have told people. in GA Insurance Hi - Just an FYI for those of you who have BC/BS of any state that will cover MGB's!! I have BC/BS of Michigan and had MGB with Dr R on 01/07/2002 - I was preauthorized and per usual am still fighting with BC/BS of Michigan for payment. I am 3 1/2 months post-operative and I just got a check for Dr R. I called BC/BS of Michigan and this is my understanding of what they are going to pay. First, Dr Rutledge is out-of-network - so make sure you have a letter of referral from your MD and they should pay Dr R as if he is in network. I got a check for $905.00 and they approved $2,500.00 - so I should be getting another check for about $1,600.00. I sent them the receipt from Dr R's office for $17,000.00 with the letter Dr R provides with the CPT-4 codes. Then, I sent them a copy of my itemized bill from Regional Medical Center for $24,000.00 and we will see what they pay - I am hoping for about $14,000.00 - which would mean that they would reimburse around $16,000.00 of the $17,000.00 bill. That would make me a very happy camper! I guess we will just have to wait and see. Carol H Dr R - MGB- 01/07/2002 268/242/228/215/209 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2002 Report Share Posted April 22, 2002 , Relax- the global bill is only $17,000.00 and that is what I paid BUT BC/BS wants seperate itemized bills and so - you send them the global bill from Dr R and then they want an itemized hospital bill. It does not really matter how much the bill is because BC/BS has only certain amounts that they reimburse for services no matter how much the bill is. But YES the bill you receieve from Medical Center is $24,000.00- but remember you have already paid this bill. Carol Insurance > > > Hi - Just an FYI for those of you who have BC/BS of any state that > will cover MGB's!! > > I have BC/BS of Michigan and had MGB with Dr R on 01/07/2002 - I was > preauthorized and per usual am still fighting with BC/BS of Michigan for > payment. I am 3 1/2 months post-operative and I just got a check for Dr > R. > > I called BC/BS of Michigan and this is my understanding of what they > are going to pay. > First, Dr Rutledge is out-of-network - so make sure you have a letter of > referral from your MD and they should pay Dr R as if he is in network. I > got a check for $905.00 and they approved $2,500.00 - so I should be > getting another check for about $1,600.00. I sent them the receipt from > Dr R's office for $17,000.00 with the letter Dr R provides with the > CPT-4 codes. > > Then, I sent them a copy of my itemized bill from Regional > Medical Center for $24,000.00 and we will see what they pay - I am > hoping for about $14,000.00 - which would mean that they would reimburse > around $16,000.00 of the $17,000.00 bill. That would make me a very > happy camper! > > I guess we will just have to wait and see. > > > Carol H > Dr R - MGB- 01/07/2002 > 268/242/228/215/209 > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2002 Report Share Posted April 22, 2002 That is a relief ---- I was going to say that if it really was $41,000 then it costs as much as the RNY! I know that Durham Regional only got about $1000 for the $11,000 that they billed CIGNA for me. in GA Re: Insurance , Relax- the global bill is only $17,000.00 and that is what I paid BUT BC/BS wants seperate itemized bills and so - you send them the global bill from Dr R and then they want an itemized hospital bill. It does not really matter how much the bill is because BC/BS has only certain amounts that they reimburse for services no matter how much the bill is. But YES the bill you receieve from Medical Center is $24,000.00- but remember you have already paid this bill. Carol Insurance > > > Hi - Just an FYI for those of you who have BC/BS of any state that > will cover MGB's!! > > I have BC/BS of Michigan and had MGB with Dr R on 01/07/2002 - I was > preauthorized and per usual am still fighting with BC/BS of Michigan for > payment. I am 3 1/2 months post-operative and I just got a check for Dr > R. > > I called BC/BS of Michigan and this is my understanding of what they > are going to pay. > First, Dr Rutledge is out-of-network - so make sure you have a letter of > referral from your MD and they should pay Dr R as if he is in network. I > got a check for $905.00 and they approved $2,500.00 - so I should be > getting another check for about $1,600.00. I sent them the receipt from > Dr R's office for $17,000.00 with the letter Dr R provides with the > CPT-4 codes. > > Then, I sent them a copy of my itemized bill from Regional > Medical Center for $24,000.00 and we will see what they pay - I am > hoping for about $14,000.00 - which would mean that they would reimburse > around $16,000.00 of the $17,000.00 bill. That would make me a very > happy camper! > > I guess we will just have to wait and see. > > > Carol H > Dr R - MGB- 01/07/2002 > 268/242/228/215/209 > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 22, 2002 Report Share Posted April 22, 2002 That is INCREDIBLE NEWS! I'm so happy to hear it cause I know MANY have BCBS! That has to give some hope. in OK MGB 3/29/2001 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2002 Report Share Posted May 30, 2002 It is my understanding that he is not " taking " any insurance. If you can get your insurance company to pay either him or the hospital, etc. that is great -- but the total amount of $17,000 is still what will be due regardless of what the insurance company pays. There are other MGB surgeons other there that apparently do take insurance though. in GA insurance And is Rutledge taking any insurance? _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2002 Report Share Posted May 30, 2002 No insurance. Money up front only. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 , I'm having the same problem with BC/BS of Pennsylvania. I live in Virginia and sent a letter to the commissioner, but they forwarded it to Pennsylvania. I don't understand why they won't pay the global billing. It is accepted with prenantal patients. Connie(Va) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 13, 2002 Report Share Posted December 13, 2002 I have never seen " global billing " for prenatal patients except for the physician's fees.... I think the problem here is that the " global bill " includes the hospital, the anesthesiologist, etc. Good luck! in GA > Re: Insurance > > > , > > I'm having the same problem with BC/BS of Pennsylvania. I > live in Virginia > and sent a letter to the commissioner, but they forwarded it > to Pennsylvania. > I don't understand why they won't pay the global billing. It > is accepted > with prenantal patients. > > Connie(Va) > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 22, 2003 Report Share Posted March 22, 2003 Hi Kat, I know you are very disappointed and I already posted to you on another list. The message bears repeating. Appeal! Don't give up! You can win this! Alice > Hello everyone! > > Well, my waiting is over. It's not good news-they won't cover my > implant I'm a little depressed now. I'd call and cry to hubby > but he's in the field without his cellphone. I think I'm going to go > crawl in a hole now! > > Kat D in Wyoming > Surgery July 4th > waiting on insurance --got it & denied > www.geocities.com/jandkdewitt/deafnesspg1.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 22, 2003 Report Share Posted March 22, 2003 Kat, I agree with Alice - appeal Appeal APPEAL!! Alice - isn't it true that Kat can get help from Cochlear if she was planning to get the Nucleus? Nuked 9/28/00 Hooked 10/26/00 I SUPPORT OUR TROOPS! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2003 Report Share Posted June 8, 2003 What state are you in? Connie insurance > Does anyone know of an insurance company that will accept a person > with hepatitis c? Our insurance company, Mutual of Omaha will no > longer write policies for major health and hospital after December 1, > 2003. We would appreciate any help we can get. Terry > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2003 Report Share Posted June 8, 2003 What state are you in? Connie insurance > Does anyone know of an insurance company that will accept a person > with hepatitis c? Our insurance company, Mutual of Omaha will no > longer write policies for major health and hospital after December 1, > 2003. We would appreciate any help we can get. Terry > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 I live in Folsom, Louisiana. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 I live in Folsom, Louisiana. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 Thanks for trying. I did get in touch with Louisiana Health plan for high risk people. It covers $100,000.00 per calendar, which is not enough if something serious happens to my husband or myself. We are looking for something else, but as a last resort, it is better than nothing. Terry Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 Thanks for trying. I did get in touch with Louisiana Health plan for high risk people. It covers $100,000.00 per calendar, which is not enough if something serious happens to my husband or myself. We are looking for something else, but as a last resort, it is better than nothing. Terry Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 I'm sorry. I don't know anything about Louisiana. In Texas, there is a Texas Risk Pool that will cover hep c under certain circumstances. You might want to get in contact with your Louisiana State Insurance Commission to see if they have something like that. Connie Re: insurance > I live in Folsom, Louisiana. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 I'm sorry. I don't know anything about Louisiana. In Texas, there is a Texas Risk Pool that will cover hep c under certain circumstances. You might want to get in contact with your Louisiana State Insurance Commission to see if they have something like that. Connie Re: insurance > I live in Folsom, Louisiana. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 also, In Texas at least, if you are working, and your employer's insurance changes, they can't deny you coverage, or when you change jobs, if you sign up in the allotted time. Alley SFF_Romance SFF_Writers/ SFF_Texas Texas_Writers/ DFW_Authors AdultAuthors Critical_Critters writingandpublishing critique_group Art_Of_Texas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 also, In Texas at least, if you are working, and your employer's insurance changes, they can't deny you coverage, or when you change jobs, if you sign up in the allotted time. Alley SFF_Romance SFF_Writers/ SFF_Texas Texas_Writers/ DFW_Authors AdultAuthors Critical_Critters writingandpublishing critique_group Art_Of_Texas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 Dear Terry: Best of luck to you. I was in a similar circumstance about the time they decided I needed a liver transplant. They had quoted me a price of about $350,000.00. We were really scared. Luckily, I was able to get disability, which got me Medicare. I still haven't gotten the transplant but at least I can pay for it now! Connie Re: insurance > Thanks for trying. I did get in touch with Louisiana Health plan for high > risk people. It covers $100,000.00 per calendar, which is not enough if > something serious happens to my husband or myself. We are looking for something > else, but as a last resort, it is better than nothing. Terry > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2003 Report Share Posted June 9, 2003 Dear Terry: Best of luck to you. I was in a similar circumstance about the time they decided I needed a liver transplant. They had quoted me a price of about $350,000.00. We were really scared. Luckily, I was able to get disability, which got me Medicare. I still haven't gotten the transplant but at least I can pay for it now! Connie Re: insurance > Thanks for trying. I did get in touch with Louisiana Health plan for high > risk people. It covers $100,000.00 per calendar, which is not enough if > something serious happens to my husband or myself. We are looking for something > else, but as a last resort, it is better than nothing. Terry > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2004 Report Share Posted January 27, 2004 , this is absolutely fascinating and highly informative. I would not have known about Dr. Boachie's involvement in providing surgery for needy patients in Ghana. Certainly everything I hear about some African countries these days makes me wish that I had something to offer myself -- such horrendous suffering, so many people living lives that we in the U.S. can scarcely begin to imagine. I must admit I am still perplexed at the news that surgeons here are now taking NO insurance. Is there still some way that patients can get reimbursed for surgery through their carriers? How can a patient afford a standard surgical fee without going broke for life? And so often patients already disabled by spinal deformities are the least able to afford expensive operations to fix their problems. This is deeply worrisome. Do you see any long-range solution? Insurance I don't know about other areas of the country, but more and more physicians here in Northern California have stopped accepting insurance. All of my (now ex) Stanford doctors stopped accepting insurance several years ago. In each case, the letters they sent out told me that they could not continue operating at a loss. In general, if doctors offices are losing money (and I think that many are), then I'd rather pay more out of my pocket, and still have access to good healthcare. In any event, my insurance reimburses me for out of network service, so my visits weren't completely out of my pocket. In the case of Dr. Boachie, he travels to Ghana several times every year, and to Barbados occasionally, to perform surgery on the most needy of patients who would not otherwise have access to even poor healthcare for their spinal deformities. The organization that he founded is F.O.C.O.S. (http://orthofocos.org). Not that it's necessarily justification for not accepting insurance, but I suspect that this strategy allows him to fund F.O.C.O.S. This is a topic which should be of interest to anyone who will require expensive healthcare in the future. Physicians and hospitals will not continue to operate if they can't make a profit. I obviously don't have the answer, but hopefully something will be done before our access to good healthcare goes away. By the way, I'm sure most of you have seen evidence of how HMO/PPO contracts reduce the amount paid, but I have one that really shocked me. A hospital bill of $56,349.50 was reduced by Blue Shield PPO to $7,737.00. Since it represented a week of inpatient care, I truly doubt that the payment came close to paying the true costs. -- Support for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2004 Report Share Posted January 27, 2004 ... When one has PPO insurance, and is seen by a physician who doesn't accept insurance, one can get partially reimbursed. I'm sure that coverage varies, but in my PPO, if I go out of network, I have to pay a deductible and coinsurance, neither of which I have to pay for in network covered services. -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2004 Report Share Posted January 28, 2004 Thanks for the clarification, . Re: Insurance ... When one has PPO insurance, and is seen by a physician who doesn't accept insurance, one can get partially reimbursed. I'm sure that coverage varies, but in my PPO, if I go out of network, I have to pay a deductible and coinsurance, neither of which I have to pay for in network covered services. -- Support for scoliosis-surgery veterans with Harrington Rod Malalignment Syndrome. Not medical advice. Group does not control ads or endorse any advertised products. ------------------------------------------------------------------------------ Quote Link to comment Share on other sites More sharing options...
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