Insurance repeatedly states my procedure is fully covered, but hospital still wants to bill me?
Basically as the title says: I have contacted my insurance multiple times to confirm this. I’m having a bi-salp done in August, and according to multiple representatives I’ve spoken with at Blue Cross, this procedure is 100% fully covered (appointments, the surgery, anesthesia, everything) due to the Healthcare reform act as long as the hospital is in-network, and the diagnosis is for sterilization. I have been told the ONLY way this procedure would be subject to my deductible/copay/anything else is if it was diagnostic, and being used as a treatment for a medical condition.
I do not have any medical conditions this would be a treatment for. I expressed heavily to my doctor during the consultation that I want this done purely for sterilization so that I can get off of hormonal birth control. At this point I feel like the only legal way they could bill it would be for sterilization, since my health records would not support it being used as a diagnostic treatment for anything. Both my OBGYN and the hospital it will be done at are both in-network.
The procedure code is 58661, and I have confirmed multiple times again with Blue Cross that yes, this procedure and everything associated with it are 100% fully covered due to the Healthcare reform act. My OBGYN billing office was not aware of this act when I first called them to double check everything, and they told me that they were told by Blue Cross that I owe part of my deductible, as well as additional charged the hospital may add. I am currently waiting for a call back from them to see what diagnosis code they sent.
At this point, should I even worry about the charges since I have gotten confirmation multiple times from multiple people at Blue Cross about this being covered?? I still have time to get this sorted out, I’m just trying to understand what might happen. Thanks in advance!