$275 per head bump... hmmm

[susandennis]

I got Explanation of Benefits today for my head bump removal and, unless I'm reading this wrong, I owe the clinic another $734.82 (outside of the co-pay). I could easily be wrong. I so rarely deal with medical stuff that I've never learned to decipher it. I'm guessing that if someone wants me to pay them $734.82, they will send me a bill or at least give me a ringie ding. How did I not figure that this was going to costd me? And so much?

I didn't even consider that it would hurt or cost me. Do not trust me with important stuff because clearly I am an idiot.

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I took a nice long walk to the Market - way too crowded - and then up through downtown to the groddy movie theater. I did get $.50 off my ticket because I am old. I'm only a little old so I was ok with only $.50 off but if I live another 20 years, they had better do better than a fucking 2 bits. Just saying.

The movie didn't suck but it wasn't that great either. I remembered most of the plot from reading the book and while Matthew M is pretty, it's not that pretty giant size. He's prettier tv size. But it was ok.

They conveyor belt sushi was much better. At least there, when the service sucks, you don't starve. You do have to wait for a long time for water and then for your bill but at least you can eat good while you wait.

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A place I have wanted to try sent out a Tweet today that they are going to start opening on Sundays tomorrow morning. So now I know where I'm going for brunch.

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The vuvuzelas are pouring out of the stadium now. It was not a packed house so hopefully the horns will be gone in just a little bit and I can open the door again. It's lovely outside - just perfect for having the door open.

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I think now I'll have a little NCIS with a side of bear knitting.

Comments

[howeird]

Explanation of Benefits
Hmmm. On some insurance, if you don't get pre-approved for an elective procedure they charge you as if you're not insured until the doctor sends them documentation saying it was necessary surgery. Wait for the doctor's bill before you panic.

Getting insurance clearance first is always a good idea - I was asked by my doctor to have a sleep study done, but bailed when insurance said they didn't cover about $4,000 of the proposed charges.

[susandennis]

Oh. Thank you!! You made me re-think and re-read and remember and likely save nearly $300 bucks!

The doctor told me that my insurance would cover the procedure (since one of the sites was suspicious).

I did not even think or really know about pre-approval. How does that work? Do I call the insurance and ask them? Or tell them to contact the Dr. office for details and then get back to me?

BUT, you also got me thinking about my deductible. I thought I remembered something funky about the deductible from my boss and so I dug back through stuff and discovered that

1. Our deductible is $2k for individuals BUT there is some kind of special reimbursement if your deductible goes over $500. The only trick is you have to apply for it. Simple form and a stamp.

So it appears that I'll only have to pay the $500. Which actually seems reasonable - to have to pay the deductible and the deductible being - essentially $500.

But,

2. Good plan to not even sweat it until I get a bill. I have done the research and I printed out the simple form.

THANK YOU!

[howeird]

The clinic I go to does the pre-approval paperwork and schedules the work for at least a week down the road to allow time to get an answer. But I have to call the insurance company to find out if there's a deductible or if they only pay a % of the procedure.

[susandennis]

Gotcha. You give good insurance thinking, that's for sure, and I'm really grateful. Since the only thing I normally use is the drug claims, I'm just not that sharp with the rest. I think I need to get smarter. Especially if I'm going to keep banging myself up!

[howeird]

Thanks! It's all recently acquired - I was with Group Health and Kaiser, where everything was self-contained and there was no paperwork up till January, then had to go with Blue Cross, and it has been an education.

[susandennis]

You are very kind to share!

[theryn.livejournal.com]

The 734 may not be the final price. Assuming that your doctor is in-network the insurance company will get the doctor to write off a portion of the cost even if they don't cover any of it themselves.

[susandennis]

cool. thanks!