Reasonable and Customary fees - Help

[Guest guest]

Hi

After researching surgery for a year, fighting insurance, hiring

Walter Lindstrom and then finally having to change insurance I got

approval and went ahead and had a DS on 6/12. I just hung up from my

insurance company CoreSource and they advised me they only paid

3,484.12 towards a bill of 12,146.00 based on reasonable and

customary fees. They said they may pay more once they review the

operative report. According to my bill I had a Biliopancreatic

(4750.00), Gastrectomy (3364.00), Appendectomy471(1432.00) and a

Enteroenterostomy (2456.00) It looks to me that the insurance

company only paid against the Gastrectomy. Any thoughts on this, has

anyone else had to fight this battle? I expected to have to pay

something due to resonable and customary charges, but I did not think

they would only pay 1/4 of the bill. This would leave me 8600.00 to

pay, I think that is extreme.

Thanks,

DS - Dr.

6/12/01

-50 lbs.