ell lamont
Junior Member
What is the name of your state? Illinois
a general surgeon contracted upfront fee for services inclusive of his procedure, OR( surgery center) an anethsesia**************and collected cash up front for an elective procedure, (abdominal plasty) with many med/ physical complaints ie: muscle separation, gi, pain, etc....He would not bill upfront, I paid cash. In the mid of the procedure...he does an "add on" procedure....(hernia repair). He billed my insurance 1 wk post surg. for the hernia repair...and was paid for the add on procedure 30 days later. (not coded as an add on). 90 days post surg. I asked for the anesthisia company and the surgeons office to bill for me so I could recieve an EOB for self reimbursment. The anethsia co. did bill on my behalf and my insurance paid the claim. I never heard from my ins. co. so I called them. No claim was ever submitted. 120 days post surg. as I was back in the surg. office, I told them no claim was processed. They agreed to submit for me...again for the OR and the actual procedure. 75 days later, I was paid by my insurance. The surgerycenter said the money I recieved was theirs. Th surgery suite sent me a bill for 16 thousand dollars. a. How can they double bill me? I contracted a fee upfront with the surg. on behlf of the surg center (he owns it) and paid it upfront. B. it is evident they never sent my claim but tried to pull one over on my insurance co.....is this legal? ( to bill two times for the OR...once to me and once to my insurance because the added on a procedure and billed for med. supplies, (again, surg time, medicine..) which said was included in my cash for service bill I paid upfront. the bill to my insurance which they have now billed me for is 10 times the amount he agreed to bill me for. I would like to know what the law is for add onprocedures and if it is allowable to bill twice for the facility and supplies.
a general surgeon contracted upfront fee for services inclusive of his procedure, OR( surgery center) an anethsesia**************and collected cash up front for an elective procedure, (abdominal plasty) with many med/ physical complaints ie: muscle separation, gi, pain, etc....He would not bill upfront, I paid cash. In the mid of the procedure...he does an "add on" procedure....(hernia repair). He billed my insurance 1 wk post surg. for the hernia repair...and was paid for the add on procedure 30 days later. (not coded as an add on). 90 days post surg. I asked for the anesthisia company and the surgeons office to bill for me so I could recieve an EOB for self reimbursment. The anethsia co. did bill on my behalf and my insurance paid the claim. I never heard from my ins. co. so I called them. No claim was ever submitted. 120 days post surg. as I was back in the surg. office, I told them no claim was processed. They agreed to submit for me...again for the OR and the actual procedure. 75 days later, I was paid by my insurance. The surgerycenter said the money I recieved was theirs. Th surgery suite sent me a bill for 16 thousand dollars. a. How can they double bill me? I contracted a fee upfront with the surg. on behlf of the surg center (he owns it) and paid it upfront. B. it is evident they never sent my claim but tried to pull one over on my insurance co.....is this legal? ( to bill two times for the OR...once to me and once to my insurance because the added on a procedure and billed for med. supplies, (again, surg time, medicine..) which said was included in my cash for service bill I paid upfront. the bill to my insurance which they have now billed me for is 10 times the amount he agreed to bill me for. I would like to know what the law is for add onprocedures and if it is allowable to bill twice for the facility and supplies.
Last edited: