Post-op Insurance question! Kinda ot-ish?

[Jame0223]

Hey Ladies! Remember me!? I am now 7 weeks post op! Wooh and recovered nicely. I have a question though. I have insurance that is based on 500$ deductable with 90/10 for everything else. I pay 10% of everything if you didn't get what I mean. So the bills have started to roll in and for everything my insurance sends me a statement. I got a surprise this morning! I got one that says I will be responsible for 1400$. WHAT?! It was posted under SU - Surgical Fees. Well I paid 200$ when I went in and also paid my surgeon as well, who is my OB, exactly what they told em it would be. Well now I get this bill for some lady, I don't know who the heck she is. But it says RNFA by her name. I looked that up and it stands for Registered Nurse First Assistant. I called my OB and asked them who she was. She apparently assisted my doctor during the surgery but I don't remember being introduced to her..and if even if I was...noone ever said that I would be getting charged for an assistant! My insurance won't cover any of it so that means I will be getting a bill for 1400$! When I got the quote for the surgery, the lady on the phone said it would be 80$(after insurance) for my dr to operate and she said that it would be around 1100$(before insurance) for the hospital stay/care and then the anestesiologist. Noone ever said ANYTHING about having to pay for an assistant. Especially one that doesn't take my insurance. So I had to call the surgery scheduler and leave a voicemail about how this lady ended up on my surgery and why the heck am I getting charged for a nurse?!

Does this seem right to you? My mom says that this isn't fair and that I should fight it since I was never notified. I remember being in pre-op and meeting the anestesiologist, a couple nurses, my dr and his student that was going to watch...I wonder if this RNFA works for the hospital...This doesn't make any sense! I can't pay for that anytime soon!

[cirella]

Hi, I'm sorry, I don't know what kind of surgery you had.  I'm glad to hear you're recovering well, though.

If you had a hysterectomy or such it is common for your GYN to be assisted, either by another doctor or assistant, as in your case.  This is because the laparoscope and tools used for surgery are too many for just your doctor to hold it all and still perform your surgery.  An experienced person is needed.  

I'm sorry you weren't told.  Actually, I wasn't told, either, and was surprised when I got an EOB for another GYN.  When I asked about it, the above is what I was told.  I'm not sure why your insurance won't cover it.  Maybe you can speak to the GYN office and they can rebill it for you?  Someone is needed during surgery so it's not like it was a luxury.  

Sorry about all this.  Good luck.

[Jame0223]

I actually had a laparotomy to take out a 2.5 cm dermoid cyst...I understand why she was there and what she might have been doing but seriously billing me for some nurse's assistance? It doesn't make sense and when they lady was scheduling my surgery shouldn't she have assigned someone that was covered under my insurance if she knew there would be another bill coming?

[cirella]

Hi, you should call the GYN just to talk with them about it.  I know it's frustrating.  I've learned that just b/c a dr's office or hospital is covered within your insurance it doesn't mean that certain individuals are in the network.  But, you're right...someone should have checked into it b/c you cannot be expected to do it when you aren't aware of all people involved in your case.

A RNFA isn't just a nurse's assistant.  She/he is a skilled, registered, surgical nurse trained to assist.  

You may have noticed that you got bills for each specialty?  The GYN, lab, hospital, radiology ( to test and read your biopsy), etc.  The actual GYN office won't tell you all that, either.  Frustrating.

Good luck.  I'm interested to know what your dr office tells you.