ANA Discussion Forum

Archive => Archives => Topic started by: mellowrama on September 13, 2006, 06:35:47 pm

Title: Negotiate cost of treatment?
Post by: mellowrama on September 13, 2006, 06:35:47 pm

Hello all,

My med bills are starting to roll in and its got me thinking about what the overall costs with be with ck treatment.  Is there a ball park figure out there?  I know my insurance (glad and lucky to have it) will pay 80%...but still I'd like to know what I'm up against.

Also, I recall seeing something about someone on the AN board negotiating the cost...anyone successfull with this?

thanks, melinda

Title: Re: Negotiate cost of treatment?
Post by: ppearl214 on September 13, 2006, 07:22:29 pm

Hi Melinda,

Can I ask this please... what kind of insurance are you on? Is Barrow's Institute part of a larger, acute-care hospital?

For me, I have BC/BS, and having my treatment at a large, acute care hospital, my BC/BS covered 100% and dr office copmts only.   I did have BC/BS provide to me a list (as of now) of all charges submitted, so give me tonight to add it up and I'll let you know.

Phyl

Title: Re: Negotiate cost of treatment?
Post by: mellowrama on September 14, 2006, 05:43:02 pm

Hi Phyl,

I have BCBS...and Barrows is supposed to be in-network with my plan.  I'll call them tomorrow and go over it again, but I was concerned about the 20 %, but now I'm thinking maybe there is a cap.

thanks for your help and feedback,
melinda

Title: Re: Negotiate cost of treatment?
Post by: shoegirl on September 14, 2006, 10:32:17 pm

Hi,

I have BCBS and I only had to pay my deductible.  Do you have PPO or HMO?

Title: Re: Negotiate cost of treatment?
Post by: ppearl214 on September 15, 2006, 06:22:38 am

Hi Melinda,

shoegirl *waves hi to the AZ girly* beat me to it and was going to ask about PPO or HMO. Sounds like more PPO and I would definately call BC/BS to ask.  Do you have the diagnosis code for "stereotactic fractionated radiation"?  That is what you need to ask them as well as giving them the diagnosis info of "Acoustic Neuroma". Typically, based on certain insurance plans, they will cover the actual treatment/machine costs if done at acute care hospital.  I know plans are individual but that is the basis for the intial investigation when calling them.  If you have dr co pays for each dr appt, that will be considered. What I have been running into are the bills for the "professional" invoices (the radiologiss, the professionals working on us) and after a couple of calls to BC/BS, I got them to pay them at R&C (reasonable/customary).

Please keep us posted on this.  Hang in there! :)

xo
Phyl

Title: Re: Negotiate cost of treatment?
Post by: mellowrama on September 15, 2006, 10:47:26 am

Hi,

Its a PPO...thanks, melinda

Title: Re: Negotiate cost of treatment?
Post by: okiesandy on September 15, 2006, 11:22:23 am

Melinda,

I have ppo Blue Choice by bc/bs.  I had to have a pre authorization before CK. I only paid about $300 after insurance. I think it would depend on your plan. Are they counting this as in network? 

When I was going to go to HEI it was out of network and it was a total mess. I could not get firm figures as to what the insurance would pay. I finially left insurance out of it and started neg. a cash price. I was shocked at the price quoted. Less than my part if I would use insurance and pay my part as out of network.

As you know I did not go that route. My CK and doctors here were in network. St Anthony's and Doc's took insurance neg. price. I did nothing. Only Dr. M showed as a preferred doctor. He refered me to the others and the insurance paid.

You need to talk to your insurance company and see what they are going to do and what they will leave for you. The hard part will be finding someone that knows what they are doing with in the insurance co.

Title: Re: Negotiate cost of treatment?
Post by: vcschaub on September 15, 2006, 12:21:06 pm

Hi! I had my surgery at House Ear Institute (HEI) and my insurance is Blue Options from Blue Cross and Blue Shield (of Florida). All my doctors and St. Vincent's Hospital are participating providers of the nationwide BC/BS network. The claims were originally made to BCBS of California and were then transferred back to my home state BCBS. The coverage was excellent.

Title: Re: Negotiate cost of treatment?
Post by: mellowrama on September 15, 2006, 03:20:02 pm

Hey Sandy and vcschaub,

I talked to BCBS (my ins) and they said I will be responsible for 20% up to $2000 max out of pocket.  Whew, much better than I thought!  I thought about trying to neg. with Barrows/docs, but figured it wouldn't be worth the trouble as there are so many doc and dept.s involved.

I'll make sure they're preferred...

thanks, melinda

Title: Re: Negotiate cost of treatment?
Post by: okiesandy on September 20, 2006, 02:29:26 pm

Melinda,

Has a request for treatment approval been submitted?  It took a month or more for my request to come back as approved. My first approval came back as GK not CK. Had to rush them to change it.

Lots of luck and I know you will be happy when this is behind you. Remember now we have to have 2 margaritas when you are in OKC!!! One for us and one for your treatment. If you don't come back soon they will just keep building.

Hug and blessings,

Sandy