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Please check your insurnce! Please check your insurnce!

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Unread 11-03-2011, 07:06 PM
Please check your insurnce!

Several weeks ago I called my insurance company and asked about my benefits. I was asked about my procedure and where I would be having it done. I was told that I would only have to pay my surgical copay of 325 plus 10% of the procedure up to a max of 3500 out of pocket. I asked about my deductable and was reassured by my insurance company that it would not apply.

Imagine my shock, surprise and near panic attack when I got a call from the hospital today who told me that I would have to pay almost 2000.00 for my surgery to happen on 11/7. I tried to explain to the hospital admissions that I had spoken to my insurance company, and that what she was telling me was incorrect. I told her I would call her back with the insurance company on the line. Boy am I ever glad I did. Not only was I correct, but I only have to pay 800.00. The hospital I am going to will not bill for the 10%. A lot of hospitals are doing that now.

Ladies, do your home work. Ask the surgeons office for the ICD-9 code and procedure (CPT) code that they used to get your authorization. They can get your authorization up to 30 days in advance. Call your insurance company yourself and make sure that they did the authorization and what EXACTLY your benefits are. If you think something is not right, your insurance company should be willing to call the hospital to explain your benefits. I am sure glad I did. Made me wonder how many have over paid and not known any different, or who cancelled because they didn't have the cash up front.

I had my pre op today but that will be a different post.
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