Hello all! I’m currently in a bit of a weird situation with my surgeon. This past August, I (from Texas) had surgery (in Virginia) to help treat a painful chronic illness. There aren’t many surgeons who specialize in the type of surgery I needed, so I chose someone out-of-network. He said I would have to pay his services out of pocket, and that his surgeon’s fee was $12K. I agreed, made a down payment and was put on a payment plan for the rest. Please note that the surgeon’s fee was the only part of my surgery that was out-of-network. The hospital, anesthesiologists, etc were all covered by my insurance and my insurance was billed over $70K for in-network fees.
After the surgery, my surgeon sent a $25K bill to insurance (separate from the $70K mentioned above and separate from the $12K I was paying him directly). I don’t really understand this as from what I’ve heard, $12K is already a really hefty surgeon’s fee and he kept insisting all along that insurance wouldn’t cover any costs. This is relevant because my insurance includes some out-of-network coverage and I could’ve tried to get some reimbursement for the thousands I paid him, but his office wouldn’t acknowledge my payment with my insurance.
Anywho, out of the $25K he billed, my insurance paid $1300 and denied the rest. Now, 5 months after surgery, his legal team has contacted me requesting signatures on the following:
A couple of insurance forms allowing them access to all of my health records and authorizing them to contact my insurance on my behalf A bunch of patient paperwork from my surgeon’s office stating that I am responsible for the full balance bill, saying I must send all reimbursement checks to them, saying their lawyers can sue my insurance under my name, etc. (For full transparency, I already signed these forms at my pre-op visit before surgery. However, they assured me at the time that my full balance would be $12K. I wasn’t aware they’d be billing more to insurance.) It’s not clear whether they lost the original forms, but I wouldn’t put it past them because the office is very disorganized.
I deal with pretty bad anxiety, so when I got this email I went into a bit of a spiral lol. It’s intimidating speaking to lawyers and while they’re (currently) after insurance and not me, it got me really fearful about what’ll happen if insurance doesn’t cooperate. I don’t want to re-sign all these forms now that I’ve seen the charges, but I technically already did. Basically, what I’m trying to figure out is: are there any steps I can take to protect myself now, or am I out of luck at this point? Thanks for reading!
submitted by /u/Terrible_Macaron
[link] [comments]Hello all! I’m currently in a bit of a weird situation with my surgeon. This past August, I (from Texas) had surgery (in Virginia) to help treat a painful chronic illness. There aren’t many surgeons who specialize in the type of surgery I needed, so I chose someone out-of-network. He said I would have to pay his services out of pocket, and that his surgeon’s fee was $12K. I agreed, made a down payment and was put on a payment plan for the rest. Please note that the surgeon’s fee was the only part of my surgery that was out-of-network. The hospital, anesthesiologists, etc were all covered by my insurance and my insurance was billed over $70K for in-network fees. After the surgery, my surgeon sent a $25K bill to insurance (separate from the $70K mentioned above and separate from the $12K I was paying him directly). I don’t really understand this as from what I’ve heard, $12K is already a really hefty surgeon’s fee and he kept insisting all along that insurance wouldn’t cover any costs. This is relevant because my insurance includes some out-of-network coverage and I could’ve tried to get some reimbursement for the thousands I paid him, but his office wouldn’t acknowledge my payment with my insurance. Anywho, out of the $25K he billed, my insurance paid $1300 and denied the rest. Now, 5 months after surgery, his legal team has contacted me requesting signatures on the following: A couple of insurance forms allowing them access to all of my health records and authorizing them to contact my insurance on my behalf A bunch of patient paperwork from my surgeon’s office stating that I am responsible for the full balance bill, saying I must send all reimbursement checks to them, saying their lawyers can sue my insurance under my name, etc. (For full transparency, I already signed these forms at my pre-op visit before surgery. However, they assured me at the time that my full balance would be $12K. I wasn’t aware they’d be billing more to insurance.) It’s not clear whether they lost the original forms, but I wouldn’t put it past them because the office is very disorganized. I deal with pretty bad anxiety, so when I got this email I went into a bit of a spiral lol. It’s intimidating speaking to lawyers and while they’re (currently) after insurance and not me, it got me really fearful about what’ll happen if insurance doesn’t cooperate. I don’t want to re-sign all these forms now that I’ve seen the charges, but I technically already did. Basically, what I’m trying to figure out is: are there any steps I can take to protect myself now, or am I out of luck at this point? Thanks for reading! submitted by /u/Terrible_Macaron [link] [comments]Read Morer/HealthInsurance