Hospital Billing

[Disneyjan]

My daughter had a procedure done in Boise, Idaho, I have excellent health insurance and the doctor booked the out patient facility for the surgery.  The hospital is now billing me for the operating room twice.  I contacted my insurance company and they have requested the medical reports for this second charge and have never been sent any.  My letters from my insurance company state this is a duplicate charge and tell me to ignore it.  They said the facility never sent any pre-authorization form to them even though they have requested this five times.  I talked with a supervisor today from the facility and she said I owe the money.  Apparently the primary doctor is charged for the room and his attending physician is also charged for using the room.  This insurance company paid for the primary doctors use, but not the 2nd doctors charges... Is this normal.  The first operating room charge is 3400.00 and the 2nd operating room charge is 4558.00.

[HH5]

One other thought - make sure these are both actually Operating Room charges, and not broader charges.  For example, perhaps one doc billed for all the pre-op and follow-up care, and the other for the actual surgery.  If that is the case, your insurance would probably reconsider paying for all of it.

[HH5]

First off, pay a little each month so you don't have this account sent to collections on you.  You should keep it current while you get everything straightened out.

The fact is that your daughter was operated on in one room, one time, right?  Unless the OR charge is 7,958 adn they are choosing to divide it up, you are on the hook for one charge, not two.  If a primary and attending doc were both involved, you may see two physicians charges, but they should not be in that kind of price range.

Get the medical records yourself.  Go to the hospital in person, sign the forms, and they will copy them for you.  They may charge you for the copies, which is a small price to pay to get this figured out.  Having the MR for you and your ins co to look at will shed alot of light on this.

You may want to get additional thoughts at the forum on www.healthharbor.com.