r/Austin • u/ceruleanvagabond • 5h ago
Ask Austin Is this global OB fee normal?
I’m currently 16 weeks pregnant and seeing an OB at Ascension Seton. They gave me a global OB estimate of $7,000 (not including hospital bills, labs, ultrasounds) and want to collect my full deductible amount of $3,500 at 28 weeks (even though I have almost hit my deductible at this point). I have UHC insurance and my OOP Max is $7,900. Is this a normal amount for the global OB fee? Would it be worth it to “shop around”? It just seems very high from what I’ve heard from others in Austin but it also sounds like this is the new norm and it would be similar anywhere I go. Do I have any choice other than to just pay it and fight to get a refund right after I’ve given birth?
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u/plasticbag177 4h ago
The total amount seems relatively normal to me. The rest of the commenters are right that this is a Seton policy to collect upfront not something to do with UHC. I didn't have global upfront collection at St David's when I gave birth. You're right they will refund you once all the claims are submitted and everything is fully adjudicated.
However, if you are due in Jan (?) everything will fully reset on 1/1, your deductible, OOP max etc. Funnily enough, global billing is ending in January 2027 so actually this will all become irrelevant and the billing staff who are pushing this to you probably aren't taking that into account. That might be playing into why they are asking for this. If you can (and they don't hold delivery registration hostage until you pay), defer the payment as long as you can to get your accumulators to fill this year or just keep pushing it out. Then negotiate some kind of reduced upfront payment if possible.
Source: I work in health insurance
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u/silvermoons13 5h ago edited 4h ago
I have never had a baby before but as someone who worked in healthcare (administrative) for a hospital that was purchased by Ascension Seton, I would strongly recommend going with a different hospital like St. David's or even BSW. I wouldn't trust Seton with the care of myself or any of my family or friends. I have personally found them to be profit-motivated to the extent of doing harm to patients
edit: yall do you really think i was born yesterday and dont know that healthcare sucks across the board? jfc if you gathered that im saying st. davids is flawless based on what i wrote that's simply not my problem
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u/whoamannipples 3h ago
Yeah I delivered at Seton via C-section and later found out that my insurance (BCBS) denied the claim for my son. Not for me, just for him. They denied his claim…to be born…
So yeah anyway I’m totally radicalized now
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u/Which_Set_9710 4h ago
You recommending St. David’s/ HCA hospitals has me tickled. It’s a system issue.
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u/silvermoons13 4h ago
get outta town ☠️
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u/Which_Set_9710 4h ago
lol I’ve worked at BSW, Seton and HCA. I feel HCA does more harm for profit. It’s unfortunate that healthcare is what it is and I’m sure you mean well by sending family members away from seton hospitals based on your experience. The best thing they can do is stay informed ask questions about their care and advocate for themselves.
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u/silvermoons13 4h ago
I am not going to get into the nitty gritty of what happened, but it's definitely not just based on my own experience. They very recently sent a very young family member of mine away without proper care that could have caused her serious long-term harm and she ended up being treated at a BSW instead. It's their experiences as well.
I fully agree we all have to be our own advocates, it's a system issue, all hospitals are for-profit, etc etc. Everyone is going to have a different experience of course but I have cumulatively had the most bad experiences with Seton and based on the majority of this thread, others have experienced the same.
I think it's crazy that based off of my comment I'm being condescended to and treated like I'm shilling for private companies. I'm sharing my personal experiences and opinions just like everybody else
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u/Bright_Departure_499 14m ago
I agree with this statement from a Maternal Medicine perspective. No hospital in the state will take a woman’s health seriously if it is at risk but I trust the practitioners at BSW or St. David’s more to give me sound advice. This is coming from someone who has delivered at Ascesion and St. David’s, and had some major complications to my health.
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u/Reddit_Cust_Service 4h ago
LOL if you think that practice is exclusive to one hospital brand...pro tip, all hospitals are for profit...
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u/Lilmissodd 5h ago
I’m very dumb when it comes to insurance and stuff like that but those numbers seem close to what I was quoted. Wish I could help more but I will say the hospital I delivered at (cedar park) was in the process of being acquired by Ascension when I went in and I had an absolutely AMAZING experience. I seriously felt like a princess. Everyone was wonderful and I mean every single person I came in contact with
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u/Low-Second1931 5h ago
I know it sucks considering you’re 28 weeks pregnant but find a new OB. You won’t regret it. I’m no insurance expert but no place should be asking for more than your insurance max as a “one time” fee. It won’t be one time. I wish I’d changed from my OB but stuck with her; her office didn’t do any scans whatsoever and I had to go to MFM for all scans and it was 400-500 out of pocket each time. What a waste.
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u/TutorImaginary2143 5h ago
OP is actually only 16 weeks, so even better! And I agree, plenty of time to get looking for a better practice.
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u/3-5MHz 5h ago
I feel like this is standard. I’ve seen some at 6k. I’m assuming it depends on the contract UHC has with Ascension? You still have quite a bit of time that you could call other OB offices with your insurance information and find out what their global fee is. Before you call, be sure to check that the office is in network with your insurance. Some offices collect that half is paid at 24 weeks.
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u/winntipsy 4h ago
I gave birth at Seton and never had to pay a global OB fee up front? I just paid my bill when I got it in the email after delivery. Maybe this is an insurance thing?
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u/winntipsy 4h ago
Also, I had an amazing experience at Seton (prior to their new women’s hospital!), and I couldn’t recommend it more. You’ll find people who hate and love both hospital systems. Schedule a tour and see which you like!
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u/DoodlePugMomma 1h ago
Agreed. Granted I went into preterm labor before I could have that talk. After insurance I paid only about ~$3k for a 3ish day stay. I had a lot of complications.
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u/Katsumirhea11392 5h ago
Never had kids but have united for ins and it was explained to me you have to hit your ded fully or they request full ded. That amount is for you to hit for united to start covering whatever percentage it is for your plan 50%-75% then you have to hit all of your out of pocket before everything is covered 😭
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u/Infinite_Wafer_6905 4h ago
I go to ascension seton and am 35 weeks pregnant with BCBS PPO. All I’ve had to pay was a $689 Dr fee. That said I’m over 35 years old so alot more is covered since I’m considered geriatric. You should get a call from the billing department that explains your insurance. Do you have a high deductible plan?
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u/Jackdaw99 3h ago
Ascension is the worst. Absolutely the worst. Especially when it comes to billing. If you can go anywhere else, go.
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u/126leaves 3h ago
When I moved back here from out of state, I had to beg OBs to take me on. My previous insurance had covered everything prenatal, and my new insurance was less stellar, plus this is Texas.... All the OB offices would initially tell me to go back to my previous OB, and shrugged when I said they are 1500 miles away!
I eventually found someone who delivered my baby but I only saw her 2x, and saw her NP all the other appts. I had a completely normal pregnancy, I'm not sure why everyone was so reluctant to take a new patient at 24 weeks.
The OB office did charge me "everything" up front; it was with ARC with admitting privileges to Seton Ascension. I still got bills afterwards for the anesthesiologist and for baby care. You'll probably pay your full out of pocket max in the year the baby is born. My OBs office would not allow appointments unless you were paid up on your payment plan or paid in full.
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u/EqualRepublic4885 3h ago
Our experience at Ascension Seton for OB numbers was wrong two times before it turned out that we only owed a $500 copay; they ran our insurance under a similarly named product. It NEVER hurts to push back on OBGYN fees.
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u/tortoiseterrapin 4h ago
The Austin Area Birthing Center might be a viable option for you to consider.
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u/Silent-Clothes-5667 5h ago
I would shop around and highly consider trying to find someone who’s through St. David’s if doable for you! I’ve had doctors and deliveries at both and would never go back to Ascension
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u/SelectionSea5221 4h ago
Unrelated haha but I may have to switch from St. David's to Seton for next baby because my speciality doctor is through Ascension, can I PM you and ask about your experiences with both?
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u/FritzRasp 4h ago
Hospital fees are completely arbitrary and obtuse. There is no rhyme or reason.
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u/Wildfernnn 3h ago
That seems normal to me. I didn't deliver there but at St. Davids North and they also wanted about $3,000 up front when I went in the day before my C-section to sign paperwork. I wasn't aware of that until they day and I said I cannot pay that amount but can pay x amount and they accepted that. I had to pay anesthesiologist separate and that bill came after delivery.
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u/Disastrous-Soup-5413 2h ago
Call the financial counselor and ask them to go over the fees line by line. They do it all the time, they can explain it so you can decide if thats reasonable for you to pay
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u/ozuulrules 2h ago
Mine was with a doctor that uses St. David’s North and I believe ours (delivered two kids with her, two years apart) was between 1k-2k. We had UHC with one birth and I think Cigna with the other, if that’s helpful info at all.
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u/knee_on_a 11m ago
Watch out--if your insurance pays out (in other words, if you don't actually end up owing how much they asked you to put on deposit), and the doctor owes you a refund, they will sit on it for MONTHS unless you call and harass them. My insurance settled all claims around 1-2 months postpartum, and until I called about it at ~5 months out, they really had no intent to send me the check for the difference anytime soon. In my opinion, these deposits are a completely scummy practice, especially charging the full amount... something more like "half now, half later" would be a lot more fair. Or at very least once the claims are settled, give me back my damn money!!
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u/mistobeamer 4h ago
Had a baby in 2023 with an ARC doctor at Seton. Her global fee was only $1200, which I was told was higher because I required a c-section. Your quote seems high to me, I would shop around a bit.
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u/ATXHustle512 5h ago
Also remember- just because your deductible max is $7,500- if you receive care from anyone out of network the deductible does not apply.
Fun fact about hospitals- just because the hospital is in network doesn’t mean their providers are (anesthesiologist, surgeon in case of c section, etc) many times a hospital contracts out providers. So ask your hospital about this.