Insurance Denial/Self Pay Info

[Guest guest]

I just wanted to pass on some information to you.

I received my surgeon bill yesterday for my Lefort 1 Osteotomy.

My surgeon billed $5,400 (for primary surgeon)

450 (for assistant surgeon)

Total Billed 5,850 (my surgery started at 7:30 and I was in my

room by 11:30 after being in recovery - so it didn't last long)

According to my Explanation of Benefits from the insurance company,

they had to write of $4,697.50 of that $5,850, because it exceeded

what was reasonable and customary. I called my insurance company,

because I thought it was a typo, but they double checked everything

and it wasn't a typo - it was correct!

Now my point of all this. If you have to pay for your surgeon out of

your pocket talk to them and see if there is a cash price. I would

have had to pay $5,850 if my insurance didn't cover this, and yet only

$1,152.50 is reasonable and customary! $1,150 is easier to swing than

$5,850!

I certainly hope this information will someone else. I know I was

totally shocked. I have yet to receive what the hospital billed yet.