I Am Absolutely F**Ked

[vivaelbirdo]

I had a small bowel resection 3 weeks ago at Mt. Sinai in New York. I did my due diligence beforehand:
1. I picked a good surgeon (Alexander Greenstein) who accepted my insurance
2. Confirmed that insurance was approved and being covered by company, and confirmed with Mt. Sinai that everything was in network and ready to go.

Well, I just got hit a $13,000 bill. Turns out, Alexander Greenstein is in network, *but his father Adrian Greenstein, whom he works with and shares a practice is not*. While Alexander performed the actual surgery, they do all surgeries together and it's billed separately. So, of the $40,000 charge from Alexander, I owe $2,000...which was expected. Of the $15,000 from Adrian, I owe $13,000.

I'm at a complete loss of how to move forward. I did everything I was supposed to do beforehand just to avoid this type of situation! I basically was informed that I am facing financial ruin because I was unaware they would both be in the operation room and that, despite sharing a practice, they take different insurance. I angers me so much...I talked to at least a dozen people at my insurance company. I spoke with Mt. Sinai's billing department, their staff and the doctors themselves about insurance beforehand and was assured everything was fine.

I don't know what else I could have done and am now facing the fact that this plus my previous hospital stay have completely destroyed my savings and am now some pretty deep debt. And this is someone WITH health insurance who did his fucking best to make sure everything was in network and approved.

 

[nogutsnoglory]

That's awful. Contact the hospitals patient assistance department. I don't know what it would be called but all assist with financial hardship and maybe they can eliminate your debt or ease it. I'd also discuss this concern with the surgeon and maybe they will waive the fee.

 

[Crohnsmomof3]

Wow! That is so wrong!!

My only thoughts are that I would bring this to the attention of your health insurance. Once when I was hospitalized I had to have an infectious disease doctor to treat me. Well, he was not in network and they billed me for the full amount. I contacted my insurance and explained to them that I was in my hospital and had no way to check on the doctor to see if they were in network and he was the on call infectious disease doctor. So, again no choice on my end.

They had me write up a statement and my referring doctors at hue he time as well. So, in the end because I had no say who treated me they covered the cost. However, I could not willingly go to that doctor again and have it work the same way.

Anyway, that said I would contact your insurance agency and explain to them that you had no idea that another doctor (not in-network) would be in the operating room at all and you had no choice in the matter. It may not work, but it is definitely worth a try.

I hope this works out for you!

 

[afidz]

"I was unaware they would both be in the operation room"
I think its best that you seek legal help.

 

[Terry]

I am so sorry to hear about the way these supposed "DRS" so completely F**Ked you over, they must be getting down to there last millions to do this to a patient, sounds like they have Tag teaming down to a fine art. I wish you all the best and hope that you beat the bastards. Good Luck. Theresa.

 

[Lisa]

I agree with contacting your insurance company again and explain to them (in writing) that your surgery was approved with 'dr x' - and you had no knowledge or control over 'dr y' being in the operating room. I would also tell the surgeon's office that your surgery was scheduled with the one doctor, and approved by the insurance company - their bringing in another doctor without prior approval by the insurance company is NOT your responsibility or 'fault' - the surgeon should have made sure all approvals were in place.

I would not make any payments until this is worked out - making a payment will 'admit' you are responsible for charges.


Tell the surgeons' office that this is under review by the insurance and make THEM (dr and insurance) duke it out - don't stress yourself out over it!

No matter what, remember that as long as you make any type of payment on a doctor bill, even if it is fifty cents a week, they CANNOT come after you and/or send the account to collections - as you are making a good faith effort to pay.

 

[Kero]

That is absolutely ridiculous! Not your fault at all. You did your due diligence only to have them screw you over. I would be seeking legal advice

 

[cleverpun]

Vivaelbirdo, have you thought about speaking with the billing surgeon directly? He is a human being and must have some human compassion. Perhaps hearing your story and understanding the circumstances he would be willing to discount his services or even cover the bill.

I was extremely fortunate and absolutely floored with gratitude when, after my emergency resection in 2001, my surgeon insisted on removing charges for his services. Sometimes people are better than you think. Although I agree with others that it could turn into a legal matter, realize also that no doctor wants to go through the hassle, cost or issues of a suit. Talk to him/her first.

 

[Geriatric Jukebox]

Hi Vivaelbirdo,

I'm very sorry that you are going through this at a time when all you should be thinking about is your recovery. I hope you can get this resolved to your satisfaction. I go to Mt. Sinai for regular checkups with Dr. Ullman,for Crohn's and I was wondering who referred you to Dr. Greenstein. If I should need another surgery I don't want to have this happen to me.

Get well soon,

Alan