Does anyone have good advice for us concerning cost of surgery with Dr. Hepworth? We were quoted under 20,000 dollars and I asked repeatedly with admissions and on the patient portal about paying before the surgery and the answer from Stephanie and hospital admissions was pay when you arrive with card or check should be no problem. But when we arrived the morning of surgery on April 1 we could not proceed to pre-op until we had paid in full of 43,000 dollars!! The staff would not let us sit up payment plan nor make separate payments with card or check. Had to be all done with debit card from the bank. WOW that was tense moments getting monies moved at our home town bank in time and they worked with us and got it pushed thru. But Stephanie was totally floored when we told her what happened and she was quoted 14-17 thousand dollars so she was quoting us the higher end of that amount in the first place! She is working on it to see if she can get to the bottom and figure out what happened. The 1 and 1/2 hour surgery was done outpatient and we were back out of hospital by the evening.
Do you have experience with working out of network? And anyone you know that would be self pay who did not have that problem?
@BuckeyePrincess I don’t have any helpful information, wish I did. I paid out of pocket with a different surgeon, and they required payment in full prior to arriving for surgery. I just wanted to say I’m really sorry this happened to you, especially right before surgery, which is stressful enough on its own.
That sounds awful, a massive difference in the price! I hope that you can get this sorted and down…
How is your daughter after surgery, and how did your other appointment go? I’ve been thinking of you all and praying for you
That’s TOTALLY NUTS!! Was it the hospital part of the charges that caused the huge increase? Usually when patients are cash paying vs going with medical insurance there is a significant discount because there’s no billing hassle or lag time in receiving payment as with med insurance. It sounds like the right hand doesn’t know what the left hand is doing in the admissions dept. at PSLH! I hope Alison is able to get you a significant refund!!
Mine is scheduled May 27 this gives me a lot of anxiety as I was assured by Hepworth office they would do a prior authorization my insurance will not cover it without one. I have a nationwide bcbs ppo and he is in network and so is the hospital. So I guess now I’ll have to hold my breath and hope they do prior Auth
I have BCBS PPO this year too, and once the prior auth is submitted/approved it should show up in your patient portal under “My Plans → Authorizations & Referrals.” You can also call the pre-auth number on the back of your card and they’ll confirm if anything’s been submitted.
If you don’t see it yet, I’d follow up with the office just to be safe, things can slip through when offices are busy. It’s much easier to sort out ahead of time than deal with it afterward.
We heard at our daughter’s post-op this am from Stephanie and Allison that they were all so shocked about the amount. This has never happened before and the hospital will be refunding us nearly half of the amount but the rates have gone up. They were sorry we had to be the guinea pig and they were sorry no communication had happened between them and billing before this when the rates have went up. Allison was concerned too as they have more patients like us coming in the next weeks!
My daughter’s surgery went well, just 1 1/2 hours in surgery removing a very large lymph node, untwisting the coratid and IJV with the large amount of scar tissue in that area. Dr. Hepworth is sending off the lymph node and scar tissue for pathology… he was surprised the amount of scar tissue present with no known injuries neither surgery in that area of her neck. Also shaved C1 1/3 inch, and shaved the lumpy styloid which was also preventing blood flow. The IJV had opened up with blood flow when the C1 was shaved. He also did an occipital vein/ artery dissection.
She is recovering as good as expected with pain control and muscle relaxants and antihistamines to calm the MCAS flares. We are so thankful for such a good doctor team here!!
Our other daughter has IJV compression about 50%. Recommendations were to keep on with upper cervical chiropractor care, trial the natural blood thinners, and maybe do PT to strengthen the ligament laxity in her neck. Surgery may improve her symptoms 25%. At this point we are going to see how the next months go.
Stephanie from his office just called today and said they would be working on it and I told her great. And when they ask for my $5250 payment ten days prior to surgery I said will you have completed my prior authorization by tha day and she assured me they would. So we will see. I’m nervous. I had a minor procedure claim denied for February with another provider because they failed to preauthorize. They had to write the entire claim off as they are in network
IM so glad your daughters surgery went well. Dr. H thinks I have one enlarged lymphnode that is compressing nerve to my ear and sits between Carotid and IJV. He will send that for pathology too. I suspect he will find the same, scar tissue. He says not he other side I have a node that is wrapped around the IJV and squeezing it. Although we didnt talk about ti, I can see by my scans my C1 might need shaving. Im glad to hear your daughter is doing well post op but sorry to hear about stress on $$$. I recently received a different notification for Dr. H office that medicare might not pay for certain procedures and codes and I might be on the hook for up to about $7K only a few weeks ago. I certainly hope they wont require that at time of surgery. This is a reminder that I will call medicare to find out what might be an issue. Thanks for giving us update Buckeye
I’m glad that your daughter is safely through surgery, and I hope that she starts to feel the benefits soon. Praying for her and for the money situations gets sorted…and I hope the conservative treatment suggested helps your other daughter
