Hello! I had a major surgery that required preauth and such at the end of October. Because I turned 26 the day prior to the surgery and didn’t get booted from my mom’s plan didn’t end until the end of the month, I used her insurance for everything for that procedure. The doctor was In Network and we had already hit out Out of Pocket Max, so I owed what I thought was nothing. Anyway, it turns out I was also billed about 12 times for D9450 (planning of the surgery) which totals about $1900.
After the surgery I applied for Medicaid (Ohio) though. Which was backdated to September for some reason?? The doctor is NOT In Network with Medicaid. Do you think Medicaid would pay this $1900 of planning charges? I’m concerned that if I say something I might instead be billed Out of Network rates and owe even MORE than that $1900. It’s weird to me that planning charges are not deemed medically necessary in the first place for a major jaw surgery… they’re supposed to just wing it?! Haha. But that’s not the question and a whole different issue.
submitted by /u/itsconnorbro
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Hello! I had a major surgery that required preauth and such at the end of October. Because I turned 26 the day prior to the surgery and didn’t get booted from my mom’s plan didn’t end until the end of the month, I used her insurance for everything for that procedure. The doctor was In Network and we had already hit out Out of Pocket Max, so I owed what I thought was nothing. Anyway, it turns out I was also billed about 12 times for D9450 (planning of the surgery) which totals about $1900. After the surgery I applied for Medicaid (Ohio) though. Which was backdated to September for some reason?? The doctor is NOT In Network with Medicaid. Do you think Medicaid would pay this $1900 of planning charges? I’m concerned that if I say something I might instead be billed Out of Network rates and owe even MORE than that $1900. It’s weird to me that planning charges are not deemed medically necessary in the first place for a major jaw surgery… they’re supposed to just wing it?! Haha. But that’s not the question and a whole different issue.
submitted by /u/itsconnorbro [link] [comments]Read Morer/HealthInsurance