Big surprise in mail

[Zxylpk]

Mine was $85k. Medicare paid 100%. Looks like someone screwed up the paperwork. They need tofix it and resubmit.

[Larry10625]

Mine was $85k. Medicare paid 100%. Looks like someone screwed up the paperwork. They need tofix it and resubmit.

Is it just me or is anyone wondering why there seems to be such a HUGE difference in the cost of this procedure. In Canada, this procedure cost about $33,000 USD.

Larry

[Gordon]

I would call doctor's insurance dept. they should have had you pre approved before anything happened. Their fault, and you should then seek legal advice. Attorney fee for advice would be a lot less than the medical bill. Hang in there and fight it.

[Lost Sheep]

When I got the mail Thursday had an EoB from my secondary insurance GEHA. They did pay a fucking dime on my surgery. It was billed at 75k billed. Said it was not covered
by my plan. This is ridiculous my dr insurance department had 2 months prior to find out this shit. Not almost 3 months post op. I it looks like Medicare paid around 15. I do not know how much they are going to write off. So far the only bill I got was for 106.00 for some preop stuff. If I had know before hand I would had serious second thoughts a working dick is not worth what 8t is going to cost us

As zxylpk said:

EoBs include somewhere on them an explanatin for the denial. Oftentimes it is the omission of additional documents, a coding error or other simple administrative detail. Read the small print thoroughly and call the number of the reviewing company.

I work for an insurance adjusting company and this is not uncommon and re-submission with the error/omission corrected is easy and simple. In the meantime, don't alienate the people who are on your side. The people who made the mistake are also the same ones you are counting on to fix it. And, like I said and in my experience, the fix is usually easy and simple. Appeals are not u8sually necessary, but are another route to solution as well.

Good Luck

[Larry10625]

I would call doctor's insurance dept. they should have had you pre approved before anything happened. Their fault, and you should then seek legal advice. Attorney fee for advice would be a lot less than the medical bill. Hang in there and fight it.

There seems to be a lot of lawyers that have free consults.

Larry

[strongagain]

In Germany you pay US$ 29,000 - everything included, even some days in hospital.

[Anonymous3]

They will pay for sex change. But penile implants are sexual dysfynction not covered. Which to me is fucked up. Iam thinking discrimantion against

[Anonymous3]

I do not know how much the are going to write off. Medicare pays some

[ThePlumber1964]

Medicare should cover, in worst case scenario, no less than 80% of the customary and usual value of the procedure, including the implant. I tend to agree with LostSheep; usually just wrong coding is the culprit of this type of denial. Just make sure you are doing everything possible to help the people at the office that are trying to have it paid. They have a vested interest to have it fixed.

[Jamesbond]

Medicare used to pay for almost all of it. Maybe a few hundred that was not covered. Way I was told is most insurance company's follow what Medicare does.
If Medicare pony picked up small amount they may have made cutbacks to program. They keep cutting back. Then over the next few years all the insurance company's might stop covering implants.

When it became public that VED where covered by Medicare the politicians stoped it. The media went with story. Right after that they stoped covering it.

Friend of mines father had by-pass surgury. Private ins co picked up everything.
Hospital said they negotiate prices with ins co. Ins co gives them hard time so they have to work cheap.
Was surprised how cheap it was. Even the Dr's fees was very low. He is a top rated Dr on area. A woman know had a mild heart attack. She stayed in hospital I think one or 2 nights. Her heart attack was so mild they where not sure she had a heart attack. She begged them to leave. Her bill was over $600K.
No surgury. Just some blood thinners and an IV and tests.
She lost her house and got cleaned out over it.

I did not have ins for a few yrs.
For minor things I think Dr's like it better if you don't have insurance.
They get to price gouge you. They all take a check or cash.