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insurance help after surgery

AnonymousUserAAnonymousUser Posts: 49,321
edited 06/11/2012 - 8:31 AM in Back Surgery and Neck Surgery
I am wondering if you could all give me a bit of advice with insurance and billings that I am getting. I have only been living in the states for 3 years so this is all still pretty new.

So i was all pre-orthorised by my surgeon and i was under the impression that everything was in network so I only had around $1300 to pay. Well everything was in network apart from one bill for "spinal monitoring" which is saying that I owe $7000 my insurance is saying that they are out of network and is paying $200.

What waved a red flag to me is that the bill had a stamp on it saying that "this bill is not a mistake and this is for all services performed" so if this company had a stamp made it must happen a lot.

I am at my wits end no knowing what to do about this bill. I cant believe that they are out of network, isn't united healthcare one of the largest in the states?

any ideas what route i should go?


  • ou can check with your insurance company....for every bill you get from a Dr, hospital or even for labwork, you should get an "EOB" (explanation of benefits). It will prove that your insurance company reviewed it and what they approved or paid. Also, I would call the hospital or company that is billing and ask what it was for. IF it's for something that's done by a company/person that is neccessary, and the only option to you for a certain mile radius, you can appeal your insurance company and they usually have to pay at an in network rate. As an example if you needed to see a urologist, but the one in your town was out of network, but the next one was 50 miles away...they would have to pay. The way your bill is worded, the only thing that associates to me is anesthesiology for "monitoring during spinal surgery". My hospital bill (when broken down) says something similar for my anesthesia. The anesthesiologist can be a seperate bill from the hospital. If that's what it is, I would check with your insurance company and see if they'll pay in network benefits because you had no choice in anesthesiologists, it was determined by the hospital. Of course if you had the choice-you would choose cheaper, in network providers!
    Good Luck!! -Andrea
  • I had a 2 level ACDF on April 13th.
    So far, I've received 1 bill from the hospital for $55k, but already received the claim from my insurance saying that I had already paid my portion, the $150 deductible.
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