Being a healthy 23-year-old woman, I have fortunately not needed any sort of major surgery since I was a child. Therefore, this is my first major operation where I am on my own dealing with insurance and its coordination with the hospital and the surgeon's office. I made a mistake and want to share in hopes of helping save one of my readers some grief in the future:
It is YOUR responsibility to make sure your insurance is accepted by the hospital and surgeon's office. Do not assume their insurance teams will do it for you. Always double check and make sure this has been confirmed. Thankfully, this was figured out early to where it was not an issue for me, but it could have a huge issue. If your insurance card is like mine, there are about six different numbers and six different companies listed to contact. I have a primary health provider through my dad's insurance in Illinois and Missouri. If I am outside of those states (I am in Tennessee) then I am out of network with my primary health provider. BUT there is a different provider available to cover me in network if I am outside of Illinois and Missouri. I was receiving two different answers: "These facilities are in network." and "These facilities are not in network." If I am in network, I pay 20% of the total costs... Out of network and I pay 50%. That is a HUGE difference. So I went into a state of panic because this surgery is in three weeks and I have no clue how I am going to pay for it if it is out of network. I was assuming that the homework had been done and it was confirmed I was in network. After spending all day on the phone with several numbers on my insurance card and people from each the hospital and surgeon's office, I was finally able to 100% confirm that everyone involved is in network! I was so relieved and am so grateful to have talked to such polite and kind women. Seriously, it makes this complicated process more bearable. Also, my surgeon said his fees should not be the $8,076 quote I had receive. That was more of a quote for having TWO jaws done. So, he is having someone re-crunch the numbers and I was told that the quotes will definitely go down! So, I received a lot of good news after having a day of panic. I had been trying to get the hospital to return my calls and answer my questions for well over a month. So, I physically went down there and found the people who I needed to talk to. I was able to give the hospital a copy of my insurance card, which really helped the process go along. For some reason I assumed the surgeon's office would have faxed that over, but I was mistaken. These are faulty assumptions I have made and I hope that it saves some of you the stress and panic I experienced last week!
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