Question
After a spinal fusion my orthopedic surgeon recommended (and I assume) wrote a prescription for a bone stimulator. The company charges $4995 for on one of these. I've received a bill from the company for $3,278.00. Both my primary (a group plan) and secondary insurance companies (in Connecticut) paid the remainder.
Checking their web-pages, my primary company's National Medical Policy considers these medically necessary. The other policy states that clinical documentation and prior authorization are required.
I haven't called my insurance company yet - I'm too afraid to find out their confirmation of the bad news. I'd wish someone had let me know how much it would cost? Can I return it? This is not what I wanted for Christmas!
Thanks -
Answer
Hi Sue!
Your best bet is to call both insurance companies to see why they paid so little and to see if you are responsible for the balance. The company who supplied you with a bone stim should have contacted your insurance company prior and advised you what you may owe, giving you a choice.
The amount seems a bit low so you need to find out what is going on.
If your insurance companies both deem that this price is overcharged due to UCR then you probably can negoitate the balance with the bone stim provider.
Good Luck!
Tricia
