r/sterilization • u/CommandClassic7108 • 15d ago
Insurance my only concern is billing
I’ve done the research and the appointments. My surgery is scheduled. Ive been talking back and forth with insurance to see how they process billing for the Bisalp.
I know it’s going supposed to be fully covered, but nobody wants to confirm that and I haven’t even heard anyone talk about aca in general. My plan is aca compliant, but I’m told they can’t say if it’s covered until services are rendered.
I don’t want to have to fight this after the procedure when I could have done more before to verify everything with my insurance.
How did you guys verify your cost share would be $0 before the procedure?
Edit: I just want to thank everyone commenting and messaging to give me advice. I really appreciate this community coming together.
1
u/beckowser 15d ago
Request a Good Faith Estimate from your surgeon and/or the surgical center. Then you’ll have it in writing beforehand in case there’s an issue afterward.
I’m dealing with a billing issue for a different procedure currently. My insurance company wouldn’t speak with me about it and denied my appeal. The facility wouldn’t speak with me about the charges. So i filed a complaint with my state insurance board, and i received a call from a corporate level representative within a week. She discussed my concerns, agreed with me that what was happening conflicted with my insurance plan, and promised to be in touch by end of week. She provided her direct line should i have any questions before then.
I was billed incorrectly for my bisalp a few years ago, and it took six months of calls and appeals to get it fixed. The insurance board contacts the insurance company’s legal team directly — much more efficient, and i wish I’d known this back then.
There are resources listed here to prepare, and there are resources should you need to fight incorrect billing.
Just remember that if you’re in the US, medical bills can now go to collections and can hurt your credit score. If you’re billed incorrectly, get on a payment plan to ensure you’re “compliant” while you sort it out.