What do I do about hospital charges that are 7X more than I expected based on previous procedures?

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      Anonymous
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      Over the past few years several members of my families (me included) have had short outpatient procedures conducted at three different hospitals and two different surgery centers within a 50 mile area of my house. I’m talking about 15-20 minute surgeries with anesthesia and recovery room. Total time in hospital/surgery center is approx. 4 hours total. My 20% copay has typically been in the $ 200-300 range (after meeting deductibles) and all have been at preferred medical centers. This is the hospital charge only.

      A few weeks ago I had to have another surgical procedure on par with these others. I get the Explanation of Benefits from Blue Cross (of AL — I’m in FL) and discover that I will owe almost $ 1500!! I got a detailed bill from the hospital showing the individual charges, but can’t get a correlating bill from BCBS. BCBS claims that they just pay off the lump sum figure assuming that all diagnostic codes were appropriate for the procedure. What do I do to dispute the high charge
      BCBS stated that they just pay the hospital 75% of the total, regardless of how much it is. I asked if they would do so even if the bill was $ 100,000 for the same procedure, and she said “Yes.”

      This is totally out of line with other hospitals in my area based on these previous procedures and bills I’ve seen.

      What should I do next?



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