FREAP CHAT Part 2 ~ Everyone Welcome to our new digs

[maddhatir]

Interesting tidbit to share: DH called me yesterday and told me that we had received the insurance paperwork on the first of the surgery bills that had been submitted. The ortho surgeon had submitted a billing of over $1900.00 for his, and his assisting, fee for the surgery. The insurance company approved $750.00 for the procedure. Unless that changes, do you think that will cause some hard feelings on the part of the surgeon??
I am getting older...I would prefer NOT to alienate any doctors in the area.

I am sorry I am laughing- not AT you!

I just want to explain something to you--I have been working with insurance companies now for 12 years- the physician can charge the insurance company a "million dollars" for your surgery however, ins companies have contracts with providers, that, for a specific code they are ONLY getting [paid XX amount of dollars for that procedure- and the physician is FULLY aware of how much he is getting from the insurance company BEFORE he bills the "million"

Now after the provider get this money from the insurance company the provider HAS to write off the difference between their billed amount and the contract amount- of course there could be copays and deductibles that the patient is responsible for- however the provider CANNOT bill a patient for the amount that is to be written off- it is illegal.

You are NOT alienating anyone- like I said- the provider knew what he was going to get before he billed it, if he had a contract and if he did not- they are fully aware they will not be getting what they billed 99% of the time.

Another FYI- I used to bill for a MD- he would charge say 60 bucks for an office visit- however, insurance was only giving him maybe 30- 40$ for the visit-

The doc makes out MUCH better when you do not have insurance b/c they are charging YOU the full amount- and you will pay it! Where ins says- sorry buddy- you know this is all we are allowing- and eat the rest.

If anyone out there has any doc or hospital bills you owe- CALL the doc or the hospital and ASK them to lower your bill- it does work sometimes. Not many people ask- but it does not hurt to try.

 

[maddhatir]

Usually there is a pro-rated charge that is less than what is submitted, so I would not be overly concerned unless they are coming to you looking for the rest. Doing medical billing for home health care we bill say $125 for a skilled nursing visit but most insurance co. pay in the vicinity of $95. These are pre-set amounts that they are going to pay. Some co. pay more while others pay less, so most places bill out the highest amount that they would receive from ANY co. and write off the difference. If he submitted 1900.00 and they are approving $750 and you are getting a bill for the difference I would check to make sure
*what your co-pay may be - some ins. cover 80/20, etc
*they aren't partially denying the claim for some stupid reason - could be it was coded wrong and usually the dr can resubmit with proper coding to get the remaining balance paid.

There are more things in medical billing as well but there are millions of possibilities. Just be willing to work with the billing department to get it resolved if a problem arises and you should be fine.

OMG!!!! We must have been typing away at the same time!

 

[mtblujeans]

Ok....I am just thinking ahead. The other knee could go out at any minute and I don't want any trouble with the doctor, see (typed in a Jimmy Cagney accent).

 

[mtblujeans]

Ewwww...we are having a blowing snow advisory warning and I have to go to PT. I don't even want to step outside.....

 

[maddhatir]

Ewwww...we are having a blowing snow advisory warning and I have to go to PT. I don't even want to step outside.....

You may want to

after reading this....

But, I am jealous! I WANT SNOW!

 

[mtblujeans]

You may want to

after reading this....

But, I am jealous! I WANT SNOW!

I understand. I hear that from a friend in Texas all the time.

 

[It's A Happy Day]

DH has been on the ****list since LAST Thursday and he has done it again He "forgot" to put the trash and recycleables out this morning I had to email him this:

to relieve my stress. Think he got the hint

 

[AlexWyattMommy]

I would think so.

 

[SHAYMARAYSMOM]

I HATE insurance companies! Money grubbing.....jerks.....ugh--

Those dumba%&es- they would have saved themselves some money- OH, and HOW ABOUT a human being from additional suffering, if they would have just approved the surgery back then! It is YOUR darn body to do with it as you please!

Oh don't get me started on this crap- sorry freaps!

Wow I hope you feel better after that vent. I feel better just from you doing it

 

[SHAYMARAYSMOM]

I feel a possible countdown ticker in your future!

When it is time to do one will you help me do it? I am a computer dumbbell when it comes to that stuff.

 

[It's A Happy Day]

When it is time to do one will you help me do it? I am a computer dumbbell when it comes to that stuff.

Any of us will gladly help you when you are ready! How goes the battle today

 

[SHAYMARAYSMOM]

today was not a bad day. They called and we have three dates they are looking at March 17th, March 21st and as a last resort the 24th. They are try to get everything and everyone set up at the sametime. I am hoping for the 17th. I told John at least I will be good and buzzed on St Pats day

 

[maddhatir]

Any of us will gladly help you when you are ready! How goes the battle today

I hope she can start the countdown ASAP! The sooner the countdown starts- the sooner she will be on the road to recovery!

 

[mtblujeans]

today was not a bad day. They called and we have three dates they are looking at March 17th, March 21st and as a last resort the 24th. They are try to get everything and everyone set up at the sametime. I am hoping for the 17th. I told John at least I will be good and buzzed on St Pats day

A St. Pats Day buzz sounds great! Maybe we will all have to get buzzed with you, in our own towns, in your honor!

 

[mtblujeans]

Well, I shouldn't have panicked. The weatherman was wrong....again. although it did snow all night last night, it is sunny and 'warm' for a winter day. No blowing snow as predicted.

 

[SHAYMARAYSMOM]

I just got a strange phone call. It was a man from Brigham and Womens Hospital to let me know that my co-pay for my surgeoy will be 500 dollars. That I knew about but he told me the date. That I thought was strange.
So the date is the 24th of March.

 

[maddhatir]

I just got a strange phone call. It was a man from Brigham and Womens Hospital to let me know that my co-pay for my surgeoy will be 500 dollars. That I knew about but he told me the date. That I thought was strange.
So the date is the 24th of March.

That IS odd that this strange man knows the date of your surgery- before you do!

Maybe your doc will call you tomorrow to verify the date.

 

[SHAYMARAYSMOM]

That IS odd that this strange man knows the date of your surgery- before you do!

Maybe your doc will call you tomorrow to verify the date.

It was kinda of wierd.He must work in the billing office. But at least I know the day. But I am not to happy having to wait for another 20 days. That seems so far away. I guess I had my heart set on the 10th.

 

[We_Love_Disney]

It was kinda of wierd.He must work in the billing office. But at least I know the day. But I am not to happy having to wait for another 20 days. That seems so far away. I guess I had my heart set on the 10th.

Doesn't this give you time to get away with DD? (Trying to look for the positive.)

 

[SHAYMARAYSMOM]

Doesn't this give you time to get away with DD? (Trying to look for the positive.)

That is true. She is on break from school next week so I need to make sure from the DR all my testing is done then I think we are going to run away.
DH said maybe we should go to FT Myers for Red Sox spring Training.