Surprise!
The finance gal got back to me this morning...the one that does the bariatric billing. Big surprises that would have changed me course of action if it wasn't just a few days before surgery.
1. Apparently Dr. Bright is also repairing my hiatal hernia...surprise! The billing office knew about it but no one ever discussed it with me. I'm not opposed mind you, but it would have been nice to talk to the doc about it first. A courtesy thing I guess.
2. My medical insurance covers bariatric surgery and, being an employee of the hospital, one of our employee benefits is that CHS will write off the 20% co-pay if you have the surgery in a CHS hospital. So I'm expecting the hospital portion of the bill to be paid off. Surprise! Because bariatric surgery is considered elective they don't cover the 20%. Nowhere in my contract does it say that write off doesn't apply to elective surgeries.
3. Surprise! My bariatric surgery cap is $25k. Anything above that is my responsibility. I could owe as much as $6k that I wasn't expecting and hadn't planned for. I budgeted for anesthesia, dietitian visits, surgeon fees, lab, pathology and x-ray. All the services not provided by the hospital that I would owe a 20% co-pay on. I never expected $6k (high estimate) in hospital fees on top of it.
4. Surprise! One more thing I didn't know is that if I have complications directly related to the surgery, they're not covered because I will have maxed out the bariatric benefit. That could put me into bankruptcy.
Had I known all this before hand, I would have waited on the surgery until after January 1st when my next year's Flexible Spending Account resets, and maybe even reconsidered having the surgery at all. Right now I only have about $345 left in my MedFlex account thanks to a colonoscopy that went badly and required surgery a week later.
The gal at the billing office is trying her best to code things out of the bariatric pocket book which I sincerely appreciate. The colecystectomy and hiatal hernia repair are usually outpatient surgeries so any charges related to that will be separated out and not charged against the $$25,000 max benefit. Oh the games we play!
At least I have insurance that mostly covers this surgery. So many people don't. Two of my friends had insurance that wouldn't cover it. One saved for years to pay for it and the other, a nurse who works in a hospital where they do bariatric surgeries, had hers done in Mexico because she couldn't afford to have it done in the states (pretty sad statement about our country's health care!)
So despite the last minute surprises I really do consider myself fortunate. I know my friends paid a whole lot more and both of them would do it again in a heartbeat. Somehow it will all work out. Right now I'm just going to concentrate on getting ready for the journey. I work a 16-hour shift tonight, a 12-hour shift tomorrow night, and I'm off on medical leave.
It is getting so close!!! I'm excited!!!
1. Apparently Dr. Bright is also repairing my hiatal hernia...surprise! The billing office knew about it but no one ever discussed it with me. I'm not opposed mind you, but it would have been nice to talk to the doc about it first. A courtesy thing I guess.
2. My medical insurance covers bariatric surgery and, being an employee of the hospital, one of our employee benefits is that CHS will write off the 20% co-pay if you have the surgery in a CHS hospital. So I'm expecting the hospital portion of the bill to be paid off. Surprise! Because bariatric surgery is considered elective they don't cover the 20%. Nowhere in my contract does it say that write off doesn't apply to elective surgeries.
3. Surprise! My bariatric surgery cap is $25k. Anything above that is my responsibility. I could owe as much as $6k that I wasn't expecting and hadn't planned for. I budgeted for anesthesia, dietitian visits, surgeon fees, lab, pathology and x-ray. All the services not provided by the hospital that I would owe a 20% co-pay on. I never expected $6k (high estimate) in hospital fees on top of it.
4. Surprise! One more thing I didn't know is that if I have complications directly related to the surgery, they're not covered because I will have maxed out the bariatric benefit. That could put me into bankruptcy.
Had I known all this before hand, I would have waited on the surgery until after January 1st when my next year's Flexible Spending Account resets, and maybe even reconsidered having the surgery at all. Right now I only have about $345 left in my MedFlex account thanks to a colonoscopy that went badly and required surgery a week later.
The gal at the billing office is trying her best to code things out of the bariatric pocket book which I sincerely appreciate. The colecystectomy and hiatal hernia repair are usually outpatient surgeries so any charges related to that will be separated out and not charged against the $$25,000 max benefit. Oh the games we play!
At least I have insurance that mostly covers this surgery. So many people don't. Two of my friends had insurance that wouldn't cover it. One saved for years to pay for it and the other, a nurse who works in a hospital where they do bariatric surgeries, had hers done in Mexico because she couldn't afford to have it done in the states (pretty sad statement about our country's health care!)
So despite the last minute surprises I really do consider myself fortunate. I know my friends paid a whole lot more and both of them would do it again in a heartbeat. Somehow it will all work out. Right now I'm just going to concentrate on getting ready for the journey. I work a 16-hour shift tonight, a 12-hour shift tomorrow night, and I'm off on medical leave.
It is getting so close!!! I'm excited!!!
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