$1000 for anesthesia
$400 for a post-up follow-up visit
It seemed every day I was getting another bill in the mail after needing surgery for a broken finger. Surgery took about 20-30 minutes to realign my joint and somehow my insurance was charged $14,000. I couldn’t believe it! I was not having open heart surgery or staying overnight in the hospital for observation.
I was thankful that my insurance at the time through work was very good and covered those major costs, but then I started getting these random bills in the mail.
It all started with my anesthesia bill, which cost $1,000. How was my surgery covered and not the anesthesia? I was very confused. I called my insurance and they told me that the anesthesiologist was out of my network. How is it that I went to a facility that was in network within my insurance, but the doctor who happened to be working that day was not covered under my specific plan? This seemed so unfair and out of my control.
If I ever need another surgery, do I always ask right before being put under if they take my insurance? It just started to expose the chaos of our healthcare system in ways I did not understand before without being a patient.
After multiple conversations for many months with my insurance company, the billing department at the hospital I had surgery, and my primary care office, I was then able to figure out that I just needed a referral from my primary care doctor for the anesthesiologist and the claim to be resubmitted.
As soon as that bill was settled, another one came in at $400 for an office visit after the 3-month post-op period! How was my office visit not covered at all? I get back on the phone with the billing department and my insurance. You know what the issue was this time? The hospital had my wrong birth date on file. Because of this, my coverage for the visit was denied by insurance.
Two very silly and fixable issues almost cost me $1,400. I think the most frustrating part about all of this was that none of it was my fault yet the bill was completely on me. I had to advocate for myself for months to get these bills fixed. Not once did the insurance and hospital system speak to one another to figure out the issue and take care of the birth date error and missing referral without me asking questions as a reluctant mediator.
This system is not set up to help support the patient. The one lesson I learned from this is to ALWAYS question your medical bill because the majority of the time there is a mistake that you shouldn’t have to pay for.
Courtney Scanlon, MD, MBA
Co-founder, Healthy Price
