My LINX journal

Here is what UHC paid for on the day of surgery:

Op Misc. Services - they paid: $11,031.94 - i owe: $1,375.77
Operating Room Services - they paid: $5,456.73 - i owe:$606.30
Chest X-ray - they paid: $32.55 - i owe:$1.04
Anesthesia, Abdomen Procedure - they paid: $371.20 - i owe: $63.80
Esophagus Procedure With Scope - they paid:$0 - i owe:$2,500

Grand Total: they paid: $16,892.42 - i owe: $4,546.91 (but $2,500 I hope they will eventually pay!)

(i don't know if it's weird to give all the numbers for everything but I figure it may help someone - so why not?)

Post Edited (NoDoubtLove) : 2/26/2013 9:02:53 AM (GMT-7)

I hope overall this is everything. The surgical planning woman told me it's normal for UHC (and most big insurances) to do this. She gave me the medical biller woman's information and told me that I flat out should not pay for the LINX $2,500 cost, they will continue to fight it as long as it takes and don't worry about it. That makes me feel so much better!

So all-in-all I guess I did get billed but shouldn't have to pay and don't have to make monthly payments on that part. I will have to make payments for the $2k I do owe the hospital for my part of the copay.

I'm not really worried as of yet. I have that $2k to worry about first and the misc. bills from the past sucky GI doctors to pay first. Medical bills will get you! Jeez!

Gastricman said...
NDL,

Yep. Copays could be a big financial hit.
Let us know how it all goes...

GM

P.S. I sent you an email.

That's the pain of it all! Copays!! I do have the more expensive insurance through work - so I hope that helps me a bit.

I get stressed because if you have 1 prodcure/test there are 3 bills coming in for it. All 3 want their money now, so multiply that by all the tests I've had and it's like 15 places wanting money or payment plans. They need to realize I can't pay $50 payment plans each month because it all adds up! I have paid some off (the like $30 here and there ones). As long as they are polite and work with me we are good. KNOX sounds like they will just hold off on everything for a bit - so that helps!

GM - I answered you :)

NDL,

UHC declined $4996.00 which was the charge for actual linx and 1249.00 for assistant helping with the linx insertion. My total bill was $30,000 for hospital and linx. I owe $3500.00 of which is my co pay after insurance has paid. And I would owe the 4996.00 and 1249.00 since UHC backed out. Of course, the medical billing dept is still appealing it and told me not to pay on this portion of it as of yet. If it does not cover it, I will owe almost $10,000. I am making the 100.00 a month payment as of now, and of course copays to other various doctors that I have seen over the past 3 years in an attempt to get help with the LPR/GERD.

Seems like the medical billing department is telling you the same thing that they are telling me. Not to worry, not to pay this portion yet, and that they will keep appealing for as long as they are able too. My linx was put in last May 2012. They are still trying to get this paid and it is almost a year. Was a pain!!!

Keep us updated if you find out anything else.

NDL,

No, ask away. I have no problem being completely honest on this forum.

Thanks for your info too. Hugs to you.

I had been told back in 2005 I had a slight one. The last 2 endoscopies (both from 2012) didn't mention anything of this - so I assume not anymore :/

KitKat880 said...
NDL- Sorry to hear about your issues with UHC. I think it's really awful that insurance companies can approve procedures and back out of paying them. Perhaps this is an area where the government should be more involved in healthcare....

Side note: Hiatal hernias do not always show up during an endoscopy. I have a small one, about 2 cm. It appeared during my barium swallow, but my GI doc didn't see it during either of the two endoscopies he performed. If it is a sliding hiatal hernia, your stomach isn't constanly pushing its way up into your diaphragm, which is why it may not be noted during an endoscopy.

That IS where government should put their noses!

The surgeon didn't mention about a hernia, I think I asked? I don't remember for sure. I probably should ask just to verify. I want to get all my medical records - I like to read through them :)

BEACH-GIRL said...
NDL,

Also, sometimes they put different info in the notes that they don't tell you.

That is the part I like to know.. what other notes they wrote!

NDL - I hope that that bill can be faught! I'm scared now to invest in getting the Linx. I guess we'll see.

I scheduled a consultation with a surgeon at USC, but unfortunately it's not the one I want because that one only sees patients on Tuesdays and I can only go on a Thursday and Friday, so I don't know what I'm going to do.

shrtcak81 said...
NDL - I hope that that bill can be faught! I'm scared now to invest in getting the Linx. I guess we'll see.

The hospital is fighting the $2,500 and honestly if I had to pay $50 a month for years on end it would be worth it. I feel so much better, I don't have to be afraid I'm causing myself cancer, just everything. Obviously I don't want to pay that - I don't have that money BUT now that I feel so better I'm MUCH happier and nicer LOL

I did drive there for them. I drove up for the consult then we scheduled the 3 tests for 1 day of fun. So that was the 2nd time I went up and then surgery was the 3rd and 4th time was my 2 week checkup after the surgery. I don't have to go back until the 6 month, maybe not even then but I do have to go back for the 1 year because they do testing again.

Him & LINX are totally worth the drive - I promise!

I still haven't had any heartburn and I've been eating spicy all the time. The dysphagia has been getting better each day. I can take pills again, but I do have to be careful and ready to take a few sips of water right afterwards but they go down without pain... some discomfort but not pain.

The only thing I notice are the burps.. I can definitely burp again! I notice I burp more often than before, dunno if it's my poor diet or the LINX?

I've been sleeping through the night and no more waking up - that's the best part... before I'd wake up nonstop with heartburn.

Overall - still SUPER happy with LINX!

I love spicy foods!!

I actually haven't had but 2 beers and a mojito since the surgery. I also don't drink soda, haven't in almost 3 years. It always gave me heartburn so I figured staying off it in general is just smart... it's not healthy.

I do need to stop with the Waffle House type foods! I've gone pretty insane with food... I have to admit. But when you can't eat all that stuff for so long, when you can you tend to go nuts!! I'm a huge foodie - so it's like I'm in heaven!