Some Drs. Actually Care

[singletracker]

I had a cervical TDR in May 2010. Everything was preauthorized by the insurance, and I confirmed that the hospital was in my network, as well as, the surgeon. The only problem is that the surgeon's office visits were only covered as in-network at one of his office locations.

Long story short, the insurance paid as it should on everything until the surgeons bill came due. The primary surgeon and the assistant surgeon (also a neurosurgeon) billed out at the same amount. The insurance only paid about 25% of the assistant surgeons bill, which left me with an unexpected $8,700 bill. I didn't even know there was going to be a second surgeon involved. They also considered the primary surgeon as out-of-network, which raised my out-of-pocket maximum by $1,000. Total unexpected charge of $9,700. The insurance wouldn't budge, so the surgeons gave me a break and wiped out the remaining $9,700. I think the primary reasons were because they new everything had been preauthorized, the second surgeon was probably being trained on the ADR and they actually care about their patients. What a relief!

[Harrison]

Wow!? This is not a story one reads every day. I hope you do something nice for the doctor or crew that made this happen! Hmmm, not sure what I would do...flowers?!

[jss]

WOW!

It's a good thing that some doctors care, because the insurance companies sure don't!

Congratulations on getting all of that taken care off. And, it's good that you're still doing well.

[singletracker]

I guess the nicest thing I can do is recommend them to others. The only way that I found out about them is from word of mouth, and it's all been good. So I guess I'll spread the word also.

[Toebin]

This is certainly something that anyone having surgery of any kind needs to consider. I too was hit with a huge bill after my cervical fusion surgery. It was for the specialist that monitors my nerve conduction during the surgery and was for $7k ... a totally unexpected portion of the bill and not something I had any control of.. but...

This guy was not a subscriber to my Blue Cross insurance and they would not cover his charges.

Fortunately my employer at the time was self insured and they choose to instruct the insurance company to cover the "reasonable and customary" charges for this portion of the procedure.

There are many members of a surgical team, many of whom we never know about that are present when we have an operation. Despite making sure your facility of choice, surgeon and follow up is within your insurances network.... there may be those involved in your care who are not. And this really makes the consumers homework a LOT more difficult