$5000 bill for acl surgery?

[paulypaul89]

I am not a doctor or even in the medical field. but I have a question about a EOB that I received today. Sorry if this is in the wrong forum just looking for help.

I received a EOB stating that I was denied a claim.

I had surgery for a torn acl 2 months ago. I was quoted the cost out of pocket by the surgeon, and then paid that at the surgeon center at the time of time of surgery. I was told that this all had been double checked with the insurance company and everything was good to go. I verified this would cost quoted to me would be the final cost by my docs office, the surgery center, and my provide. This was for everything from the surgeon cost to anesthesiologist cost.

Well I received a bill today, and called my insurance company today and said the surgeons assistant (PA) was not in the network and it was rejected and that I would have to pay it.

After doing some research I found out that person is an "independent contractor" who works for himself and contracts work for my doctor.

Does this sound like a fair amount for a surgery that lasted an hour and 15 minutes?

I have been unemployed for awhile now, and I was having trouble being able to afford the original quoted cost let alone this new bill. Thanks

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[BreathDeep]

That's sounds exactly average. 4-11k is a good range from what I've seen. Anecdotal, but at my facility an acl will run you roughly $7,000.

 

[Mad Jack]

SDN is not the place for financial advice, even in regard to the medical field. It is likely you can come to some sort of arrangement in regard to the bill if you make it clear you are unable to pay, it never hurts to ask. As to the out of network billing, this is a common strategy to maximize revenue, however unscrupulous.

 

[Winged Scapula]

Closing. SDN is not for medical advice.