Hi! I’m hoping to get some advice on a large medical bill. I recently had a minor surgical procedure done that required I be under anesthesia. I have Cigna and am in LA county for reference. My surgeon is in-network, but the facility was out of network. I knew this going into the procedure, but it was the only facility my surgeon operated out of.
Prior to the procedure, I called the surgical center to understand the costs. They have a specific agent who deals with Cigna claims so I spoke with her. This associate said that I had a responsibility of $500 to pay prior to the procedure, which I paid. This was estimated after reviewing my benefits with Cigna. She said that I may owe a little more or possibly even less and get a refund once the claim was processed. She stressed that the pre-procedure estimates are very close to the final patient responsibility and not to worry.
I recently received an invoice from the surgical center. The total bill was $79k. There was an allowed amount of $24k. Cigna paid $19k. The surgical center is now saying that I am responsible for a total of $4,500 ($1,500 to meet my out-of-network deductible and $3,000 for coinsurance). In total, I now owe them $4,000 since I already paid $500. I’m really at a loss of what to do because I am unable to pay this amount and would not have had the procedure had I known it would be this expensive.
I’ve been on the phone with the surgical center for hours and they are refusing to reduce the amount at all saying that they are under a strict contract with Cigna. They also are not providing anything in writing in terms of a payment plan. The associate said as long as I show that I’m making a payments as I can then that’s good enough. Then she put me on hold to talk with her supervisor and came back and said I must pay it all within 6 months ($700/month). My surgeon’s billing office is also super confused and does not understand why I’m being charged so much either but the surgical center refuses to speak with them. Cigna is saying that this is between me and the surgical center since they’re out of network and my other option is to go to the Medical State Board of California.
Any advice on what to do?
submitted by /u/rhinestonecowboy77
[link] [comments]
Hi! I’m hoping to get some advice on a large medical bill. I recently had a minor surgical procedure done that required I be under anesthesia. I have Cigna and am in LA county for reference. My surgeon is in-network, but the facility was out of network. I knew this going into the procedure, but it was the only facility my surgeon operated out of. Prior to the procedure, I called the surgical center to understand the costs. They have a specific agent who deals with Cigna claims so I spoke with her. This associate said that I had a responsibility of $500 to pay prior to the procedure, which I paid. This was estimated after reviewing my benefits with Cigna. She said that I may owe a little more or possibly even less and get a refund once the claim was processed. She stressed that the pre-procedure estimates are very close to the final patient responsibility and not to worry. I recently received an invoice from the surgical center. The total bill was $79k. There was an allowed amount of $24k. Cigna paid $19k. The surgical center is now saying that I am responsible for a total of $4,500 ($1,500 to meet my out-of-network deductible and $3,000 for coinsurance). In total, I now owe them $4,000 since I already paid $500. I’m really at a loss of what to do because I am unable to pay this amount and would not have had the procedure had I known it would be this expensive. I’ve been on the phone with the surgical center for hours and they are refusing to reduce the amount at all saying that they are under a strict contract with Cigna. They also are not providing anything in writing in terms of a payment plan. The associate said as long as I show that I’m making a payments as I can then that’s good enough. Then she put me on hold to talk with her supervisor and came back and said I must pay it all within 6 months ($700/month). My surgeon’s billing office is also super confused and does not understand why I’m being charged so much either but the surgical center refuses to speak with them. Cigna is saying that this is between me and the surgical center since they’re out of network and my other option is to go to the Medical State Board of California. Any advice on what to do?
submitted by /u/rhinestonecowboy77 [link] [comments]Read Morer/HealthInsurance