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interstim problems with insurance!

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  • interstim problems with insurance!

    I had my sorgery in october, but my insurance is not paying my doctor the amount of his fees
    ($ 3750), they just paid $500.00!!!, now it is supposed to be my responsability to pay the remaining. The worst of all, is that I had been authorized and the doctor's fees too before my procedure!
    Can someone tell me their doctors fees and how much did your insurance paid to your doctor for the implant? and for the test? he was paid just $200.00!!!
    thanks for your answers!!!

  • #2
    Does your doctor, on the paper work that you sign, agree to take payment assignments for your bill. If so, then you are usually held to an additional 20% above and beyond the 80% deemed fair and paid by your insurance.

    If your doctor did not have you sign a sheet of paper assigning the insurance payment direct to him, you are probably liable for the entire remaining fee. However, you can frequently negotiate a fee with a doctor if you keep a cool head. Now days doctors are having to eat the fees on 1 out of every 7 patients that they see.

    Good luck!


    • #3
      Lucia, my daughter-in-law is office manager for a doctor and does all of the insurance work, too. She says the money end of medical care is getting to be a nightmare for both doctors and patients. She spend a good part of last Easter getting a primary care physician's referral for an emergency; otherwise, the specialist she works for would not have been paid--not even for emergency surgery. She was working on the referral still when the actual surgery was taking place.

      And my daughter-in-law has 2 younger children who believe in the Easter bunny. She missed all of that.


      • #4
        I am responsible to pay if my insurance doesn't pay the total amount of his fees. I can't believe that my insurance after sending te aproval letter for the interstim therapy (the test and the implant)is paying just that. The doctor's letter asked to aprove his fees ( it mentioned the total amounts of the two procedures), and they did!, Now the insurance said that the doctor agreed to received $500 instead of the total amount of his fees.