Guest guest Posted November 17, 2000 Report Share Posted November 17, 2000 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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