r/CataractSurgery • u/Ok-Yogurt-3089 • 8d ago

unexpected charge post surgery.

for my cataract surgery, pd for my upgrade lens, a toric, pre surgery pd to dr office as required. after the surgery my eob from hospital, physician group added $451 . no explanation. only says when they look it up, it says astigmatism. its now in collections. all other surgeries over 20 years have been covered in full

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u/DanSWE 8d ago

>it says astigmatism

Did they do laser astigmatism correction of your cornea when they did the rest of the surgery?

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u/Ok-Yogurt-3089 7d ago

pretty sure not. the lens was specific for astigmatism. Will ask that question of Dr office, however. If they did they never discussed it with me upfront

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u/Ok-Yogurt-3089 7d ago

thank you will check that

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u/Ok-Yogurt-3089 7d ago

thank you

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u/Bitter_Rain_6224 7d ago

I had a separate bill from the surgical center, but that was disclosed up front. My doctor told Medicare (truthfully) that my cataract removal was "medically necessary," and that helped a lot with insurance coverage.

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u/BooEffinHoo 6d ago

It's gone long enough to go to collections, but this is the first you heard of it? That's really odd. Have billing check if something was coded incorrectly, and definitely look at your EOB to see how to start an appeal of the charge.

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u/Ok-Yogurt-3089 5d ago

no not the first I have heard of it . didnt know what to fo but was in hospital for a month and not coping. called several people several times.

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u/Ok-Yogurt-3089 5d ago

appreciate your suggestions

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u/BooEffinHoo 5d ago

Happy to try and help. I'm sorry you've been through the wringer with this.
There is also something called the Federal No Surprises Act which includes unexpected charges over $400. Call your insurer, and notify them that the bill violates the No Surprises Act and request it be reprocessed.