Guest guest Posted November 18, 2000 Report Share Posted November 18, 2000 Hi , Prudential paid 80/20 on my coverage and I ended paying about $1100 total. I was also surprised at the allowable prevailing rate. DRH will not ask you for the difference. They only billed me for the 20% of the allowable charges. It made me happy. Love, Genz Wmson@... wrote: > I now know what Dr. R means when he says the insurance companies don't pay > the hospital very much. I got my explanation of benefits today concerning my > hospital stay (surgery date 10/04/00). > > This information will also be helpful to any of you who are self-pay (i.e. > how much refund you can expect out of the $11,000 deposit required). > > They were billed $495 for a private room and a total of $9313.87 for " special > services " . The " contract amount " for the private room was $45 ($38 > disallowed due to it exceeding the semi-private room rate). This is the > interesting part. Out of the $9313.87 the contract amount was $623 of which > my plan paid 80% leaving me responsible for a total of $254 out of a bill of > $9808.87. I stayed in the hospital approximately 24 hours. > > If what Dr. R says in clinic is true about the cost of the staple loads ($200 > per load) that means my insurance company didn't even pay the hospital enough > to cover the staples! All I can say is thank God for insurance and DRH > better not even think about asking me for the difference - all they are > getting is the $254 which my EOB says is my responsibility. > > That means with an 80/20 plan from CIGNA I will end up paying approximately > $1000 out of pocket - still awaiting a decision on the clinic fee - having > trouble getting any one to tell me whether or not the additional information > they requested regarding medical necessity was ever sent from Dr. R's office. > > > $1000 for a new life - I'll take it any day! > > on > MGB 10/04/00 > Preop 275 > -19 pounds in 6 weeks > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 18, 2000 Report Share Posted November 18, 2000 Hi , Prudential paid 80/20 on my coverage and I ended paying about $1100 total. I was also surprised at the allowable prevailing rate. DRH will not ask you for the difference. They only billed me for the 20% of the allowable charges. It made me happy. Love, Genz Wmson@... wrote: > I now know what Dr. R means when he says the insurance companies don't pay > the hospital very much. I got my explanation of benefits today concerning my > hospital stay (surgery date 10/04/00). > > This information will also be helpful to any of you who are self-pay (i.e. > how much refund you can expect out of the $11,000 deposit required). > > They were billed $495 for a private room and a total of $9313.87 for " special > services " . The " contract amount " for the private room was $45 ($38 > disallowed due to it exceeding the semi-private room rate). This is the > interesting part. Out of the $9313.87 the contract amount was $623 of which > my plan paid 80% leaving me responsible for a total of $254 out of a bill of > $9808.87. I stayed in the hospital approximately 24 hours. > > If what Dr. R says in clinic is true about the cost of the staple loads ($200 > per load) that means my insurance company didn't even pay the hospital enough > to cover the staples! All I can say is thank God for insurance and DRH > better not even think about asking me for the difference - all they are > getting is the $254 which my EOB says is my responsibility. > > That means with an 80/20 plan from CIGNA I will end up paying approximately > $1000 out of pocket - still awaiting a decision on the clinic fee - having > trouble getting any one to tell me whether or not the additional information > they requested regarding medical necessity was ever sent from Dr. R's office. > > > $1000 for a new life - I'll take it any day! > > on > MGB 10/04/00 > Preop 275 > -19 pounds in 6 weeks > > Quote Link to comment Share on other sites More sharing options...
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