How Much? How Much?

Camp3 · 11-03-2008, 09:17 PM

Okay so my coordinator told me my insurance pays 80% and I am responsible for 20% but no more that $4500. How much is the surgery in NC and will I my out of pocket be $4500. The info sheet says NO PAYMENT ARRANGEMENTS.. All costs must be paid before surgery. So how can they charge for a surgery before you've had it..I have united health care. Can anyone give me a gestimate or how much you've ended up paying.

bohica1224 · 11-03-2008, 10:15 PM

well I'm in Texas... so I dont know exactly how much it will cost you where you are... but I paid out of pocket becasue I wasnt lucky enough to have insurance cover mine...

BUT...

mine was 12,900 and 20% of that would be $1,580... not that bad...

MacMadame · 11-04-2008, 12:47 AM

They can charge you before you have it because they can. Shrug? Their contract with your insurance company lets them. In fact, they could make you pay the entire thing upfront and then have insurance reimburse you, if that's how they wanted to do it.

Camp3 · 11-04-2008, 10:30 AM

You are right the $4500 just stuck in my head though. I totally freaked out. Hopefully it won't be that bad like you said. Do you get the hospital bill after the surgery? Or is it all included?

Congrats on the weight loss. I guess it's totally worth the $$!! I have my series of dr. appts this month. EKG, Nutrition, Psy, and Breath Tek. I had no idea it would be soo many. But I convinced the doc not to do the overnight thing for sleep apenia. The coordinator said it would still be a few months out. So I'm aiming for Feb. when I get my tax return!

oscarel · 11-05-2008, 07:13 AM

I'm also in Texas and I went to AIGB. Make sure you submit anything the doc says isn't covered by insurance too. For me even though insurance denied the claim it went against my out of pocket and deductibles. I have a $3500 out of pocket and $2000 of that was taken up by the sleep study, I had to do 2. And I wasn't charged anything for them by AIGB!! As for the surgery, so far insurance has payed $25K to surgery center (they submitted $45K) and $1500 to anesthesiologist. I still haven't seen the doctor's charges yet. So once it's done I should be out of pocket about $2500 for everything.

Camp3 · 11-05-2008, 11:32 AM

$2500 sounds great compared to $4500. My coordinator told

The surgeon fee is $3,405.00, assistant surgeon fee is $1,021.50. Hospital fee for LAP-BAND® is $14,500 and anesthesia runs about $975.00.

Surgery center would collect around $885.30 (20% of surgeon and assistant surgeon fee's). If the hospital collect 20% then that's close to $3000. So that would make up $4000 not including antehsia.

I called UHC and they told me not to pay anything until they send back the contract amount of what they will pay and to keep all receipts in case of over payment. So even if they say it costs $14,500. UHC may only pay 10,000 and my 20% comes of that.

I can swing closer to $2000 so keep your fingers crossed for me! My forms say you have to make all co-payments before surgery otherwise it will be cancelled. I haven't even been approved yet. So I'm just going to with the flow.