I am in TX, USA.
My son needs tubes in his ear for fluid that won't drain. We received a recommendation for an ENT from our pediatrician. Took 2 weeks to get an appt but they saw him and agreed he needs tubes put in to drain his ears. We were scheduled for a Thursday appointment on Monday. Today, Tuesday, they were calling me with specifics on the numbers and asking for payment before they could authorize the procedure.
Typically I should be sent a bill and a claim should be filed BEFORE any payment, but they were able to communicate to me (and I verified) the amount that was left on his deductible and what the 20% of what I would owe after insurance.
I was expecting maybe $750 out of pocket but it was a whopping $2250 owed by me, down from a $13000 procedure. We had about $700 left in our FSA, leaving $1500 after that. I told them I wanted a payment plan and couldnt afford the rest. They started talking about how we can push back the procedure if need be but they cant authorize it without payment. New hospital policy.
I called insurance and asked wtf was going on and they were ZERO help. Stated the hospital has the numbers on their end from a contracted agreement and the numbers they have are likely accurate. I called the hospital back and said including the $700 FSA payment, what else would be needed to clear this? They said 50% of the remaining $1500 and I could be put on a 6 month payment plan.
I just dont understand how this is acceptable but I understand that hospitals have their policies and they know Im pressured to do this since its a procedure that could lead to complications down the line if not done soon.
What can I do here? I feel like Im in a rock and a hard place because IF I try to shop to a new hospital, I need to get on another ENT's schedule for the review and then get on their schedule for the procedure. Pushing this back just isnt an option.
Submitted April 18, 2017 at 12:53PM by pawsforbear http://ift.tt/2opSn66
