Crazy Surgery Billing question for any PS

[cutter]

I had surgery 2 months ago. My claim was finally submitted to insurance (BC&BS). The surgery cost $6,900 in Los Angeles which included surgery, surgery center at PS office and Anast. My wife followed up with insurance and they told her the PS had sent in a claim for $42,019.50. The PS said that I would have paid that total if I did not have insurance. The woman that does the billing there quoted sections 22 and 22-50 in the billing handbook?

Can any doctors explain this to me. Is this standard procedure? Is insurance really going to pay $6,900.00 when they see $42,019.00 being asked for?

Thanks in advance for any info.

Stu

[Puffynip]

Goes to show just how F****d up our medical system is!!!

That is an amazing figure! Something is not right!

[brama]

If your surgeon actually asked for that much money then he's obviously trying to rip off your insurance company. Id totally report him to the insurance company.

[ItsOK]

It's not unusual for the insurance to be billed more than you would have to pay if there was no coverage.  The number you gave seems excessive to me.

It's also not unusual for providers to write off the difference between the amount they bill the insurance and the amount that the insurance pays.