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 Post subject: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 12:02 pm 
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Has Isa on speed dial
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Location: Nashville
I'm not sure if I'm posting in the right thread, but I wondered if anyone had any experience with this. My kid is going in for two surgeries, and the medical center paperwork says, "Our office staff will contact your insurance company to verify benefits and eligibility. An estimate of the surgeon's fees according to the contracted rate with your insurance company will be estimated (This does not include facility fees, anesthesiology fees, radiology fees, pathology and/or lab fees) If your deductible has not been met and/or coinsurance or copay is applicable, estimated fees will be due prior to surgery. Surgery may be cancelled if payment is not received in our office no later than two business days prior to surgery."

Okay, so I get that they can require prepayment, but I will not have met my deductible yet, since the surgery is scheduled early next year. So... how do I negotiate this and/or avoid being overcharged? What info do I need to know moving forward?

Halp!


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 Post subject: Re: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 2:48 pm 
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You may have to pay the full deductible. Your insurance should reimburse you if you overpay. I've been in this situation before.

I would call and talk to someone with your insurance company.

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 Post subject: Re: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 3:18 pm 
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Making Threats to Punks Again
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Location: chicago
Yeah, I've had to pay up front for things that were partially covered by my insurance before, including paying the amount of my deductible before getting services, but calling the insurance company myself was helpful so that it wasn't a surprise how much it would be when I showed up.

In my case, I had to pay a $350 deductible plus co-insurance above that when I got an IUD inserted, so it was a pretty straightforward thing and the cost was just what they told me it would be. It does seem like during surgery and recovery those charges could be way more variable, but I would agree with lw that you will just have to pay an estimated amount and get reimbursed if you overpay.

Depending on how high your deductible is, maybe the hospital would be willing to work out a payment plan with you. It seems very reasonable that if you have a $2000 deductible or something, you might not be prepared to pay that all at once even if you would be able to pay it throughout the year.


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 Post subject: Re: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 4:08 pm 
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Semen Strong
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Location: Cliffbar NJ
I think that's pretty normal, because they don't want to risk not getting paid. I've learned the hard way to make sure that your anesthesiologist and radiologist are in network as well. It's really upsetting to get hit by a surprise bill that isn't covered by by your insurance company, and then having to fight to get it covered or pay it.

And yes, talk to the medical center about how to pay your portion. Is it a hospital or a medical center? Hospitals tend to be pretty good at working out payment plans.

And good luck with your child's surgeries. It's so hard having a kid getting ready to undergo surgery, and then having to worry about how to pay for it on top of it is just added stress you don't need.

Sending you many good thoughts.

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 Post subject: Re: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 4:23 pm 
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Semen Strong
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Joined: Tue Oct 19, 2010 7:10 pm
Posts: 21396
Location: Cliffbar NJ
I think that's pretty normal, because they don't want to risk not getting paid. I've learned the hard way to make sure that your anesthesiologist and radiologist are in network as well. It's really upsetting to get hit by a surprise bill that isn't covered by by your insurance company, and then having to fight to get it covered or pay it.

And yes, talk to the medical center about how to pay your portion. Is it a hospital or a medical center? Hospitals tend to be pretty good at working out payment plans.

And good luck with your child's surgeries. It's so hard having a kid getting ready to undergo surgery, and then having to worry about how to pay for it on top of it is just added stress you don't need.

Sending you many good thoughts.

_________________
My oven is bigger on the inside, and it produces lots of wibbly wobbly, cake wakey... stuff. - The PoopieB.

THROW A forking YAM IN THE OVEN ITS forking CHRISTMAS - LisaPunk


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 Post subject: Re: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 4:55 pm 
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Hoards Peppermint Jo-Jos
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Joined: Fri Oct 22, 2010 9:03 pm
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If you'd like additional confirmation, you might also consider contacting your state attorney general's office just to be sure this practice is consistent with state laws. There are usually some kind of consumer advocate staff who can help you out.


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 Post subject: Re: Hospital requires pre-payment?
PostPosted: Fri Dec 18, 2015 10:28 pm 
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Location: Knoxville, TN
For my first thyroid surgery, I recall someone calling me from the hospital and saying that a downpayment was required, but asking what I could afford to pay. They are probably used to people negotiating the amount. My second surgery was in the same year and I'd hit my out-of-pocket max by then, so this was only an issue the first time.


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