I don’t know where else to post this. Hopefully someone can relate. I got top surgery last month and I’m billed a surprise $14k!? Someone please help
Long story short. I have Blue Cross Blue Shield Wellmark Blue in Illinois. I’m still under my moms insurance since im 22. I just got a double incision mastectomy a month ago. I paid for the surgery or well I Thought I did two weeks before. Insurance covered 80% and I paid the max out of pocket of roughly $5k in deductibles and coinsurance a month before surgery
( total fees was $89,403. Insurance covered $83,857. So I paid $5,546)
Fast forward to NOW. Im being surprised billed another $14k for breast reduction. I requested an itemized bill and all it says is breast reduction. Nothing else. I had already called both the insurance and hospital I thought the coding was wrong, but apparently the coding is right. Insurance didn’t cover any of this new bill. Which I don’t understand at all.
I called the hospital. They told me to call Insurance. I called insurance. Apparently the office submitted a claim in June and it expired in August. Since I got surgery October 12…They didn’t have authorization from the insurance. So insurance denied the claim. Insurance agent said the hospital neglected to send another claim until October 26. Which was AFTER I got surgery. If I knew the situation I wouldn’t have gotten the surgery until insurance was all squared out.
So insurance is reprocessing the claim. I still don’t even understand the situation. I called the hospital again afterwards to communicate the situation and they didn’t even seem to understand what I was saying. Like they were playing dumb. I don’t know.
What did I pay the $5k for? Why am I being billed for another $14k? Why did the office not confirm that the insurance was all sorted out before I even got surgery? I feel like a dumbass. There’s no way I can pay this $14k. I gotta wait until they reprocess the claim again in which Im hoping insurance actually does cover something.
submitted by /u/chilloutman24
[link] [comments]I don’t know where else to post this. Hopefully someone can relate. I got top surgery last month and I’m billed a surprise $14k!? Someone please help Long story short. I have Blue Cross Blue Shield Wellmark Blue in Illinois. I’m still under my moms insurance since im 22. I just got a double incision mastectomy a month ago. I paid for the surgery or well I Thought I did two weeks before. Insurance covered 80% and I paid the max out of pocket of roughly $5k in deductibles and coinsurance a month before surgery ( total fees was $89,403. Insurance covered $83,857. So I paid $5,546) Fast forward to NOW. Im being surprised billed another $14k for breast reduction. I requested an itemized bill and all it says is breast reduction. Nothing else. I had already called both the insurance and hospital I thought the coding was wrong, but apparently the coding is right. Insurance didn’t cover any of this new bill. Which I don’t understand at all. I called the hospital. They told me to call Insurance. I called insurance. Apparently the office submitted a claim in June and it expired in August. Since I got surgery October 12…They didn’t have authorization from the insurance. So insurance denied the claim. Insurance agent said the hospital neglected to send another claim until October 26. Which was AFTER I got surgery. If I knew the situation I wouldn’t have gotten the surgery until insurance was all squared out. So insurance is reprocessing the claim. I still don’t even understand the situation. I called the hospital again afterwards to communicate the situation and they didn’t even seem to understand what I was saying. Like they were playing dumb. I don’t know. What did I pay the $5k for? Why am I being billed for another $14k? Why did the office not confirm that the insurance was all sorted out before I even got surgery? I feel like a dumbass. There’s no way I can pay this $14k. I gotta wait until they reprocess the claim again in which Im hoping insurance actually does cover something. submitted by /u/chilloutman24 [link] [comments]Read Morer/HealthInsurance