Last summer my son underwent spinal fusion surgery. After visiting several surgeons, he selected a surgeon who came highly recommended, but the doctor who performed the surgery was out of network from his insurance co. I called his insurance co. (Oxford) and was told that the company would pay 70% of the average when a surgeon is out of network. In addition, the doctor's office manager informed us prior to his surgery, that the office would arrange everything with my son's insurance co. and also told us that there would be no out of pocket cost to the patient.
After the surgery, we received the bill from the surgeon which was about $270,000. Oxford, (the insurance co.) paid the surgeon and all the others involved a fraction of the cost. They initially paid the main surgeon $7,000.00. After my son wrote a grievance letter to Oxford, the company paid another $800.00. In the letter, he received from the insurance co., the company informed my son that the plan only pays a percentage of what Medicaid would pay. That's not what I was told when I initially called Oxford. Needless to say the amount the surgeon received is way to low and I feel it is so unfair to the surgeon who helped my son. What shall we do with the medical bills that will be coming? My son doesn't have that kind of money, nor do we. My husband is retired and I work part-time. Please advise us on what to do. Thank you for any help you may provide.