Connect
← Return to Familiar with "TOPS" spine surgery?
Discussion
Familiar with "TOPS" spine surgery?
Spine Health | Last Active: 1 day ago | Replies (63)Comment receiving replies
@marietter I have talked to both Medicare and my supplemental insurance, which will pay everything Medicare doesn't cover. The problem is that many of the TOPS surgeons will not accept what Medicare pays because it doesn't pay well. I actually talked with the person in billing and she is the one who told me I may have an 11,500 out of pocket expense, despite Medicare telling me they will pay. The problem is that going into the surgery, they cannot tell you whether or not Medicare is going to pay....they only know AFTER if it's going to be covered. I'm hopeful that it will be covered!
Replies to "@marietter I have talked to both Medicare and my supplemental insurance, which will pay everything Medicare..."
@ou14mejc If your surgeon is a participating physician with Medicare , he cannot bill more than the Medicare APPROVED AMOUNT.
If he is NOT a participating provider, there is still a limit he can charge you beyond the Medicare approved amount. Perhaps that’s what he’s referring to. Sometimes there are additional procedures they cannot foresee which may add to the cost.
In the end, you must do what will help you feel better. Most physicians will work with you to pay monthly on the balance due. They don’t want your balance sent to a collection agency where they only receive a third of your balance because the agency keeps their part. By law as long as you’re paying a reasonable monthly amount, doctors will work with you.
You may also look into Care Credit to pay off the doctor’s bill, you then pay this company monthly. No interest for the first year too. Best regards.
Connect
@ou14mejc - This is not a healthcare system - this is a crap shoot where the victim too often is left holding the bag!