Submitted by Anima_EB t3_125udmw in springfieldMO
Hey guys, I'm scheduled for a minor outpatient surgery at Cox in mid April. Just got a call from them saying they want a decent amount upfront even though I have insurance. Anybody have any experience with their financial aid or other options in town? Just weighing my options before paying them. Having come from STL where the options are much better this is quite a bummer.
Very much appreciate this. Gonna be giving them a call back shortly to say this exact thing.
I just ran into this!! It’s up the the doctor/clinic. I fought it hard but in the end had to pay. They cancelled the surgery because they thought I wasn’t going to pay. I will say I never had to pay anything up front with Mercy so Cox doing this really irritated me. I spoke with Financial Services, a Patient Rep and no one would assist.
Fucking bummer dude. I assume if you just bluntly turn people away you won't get even the massive insurance payment.
It was bs. I had to pay 50% which was $1100. I was beyond pissed, I even called my insurance company to see if there was anything they could submit to Cox to prevent. But something even worse is how long you have to payoff the remaining balance. Ferrell Duncan is 12 months. I’m expecting to pay my out of pocket maximum which is $7000, no way I could pay that in 12 months.
Springfield isn't really that wealthy of an area. There is an immense older working class population. South side can get ritzy sure but what makes them think regular people can afford thousands of dollars randomly?
Tell them to send you a bill because you pay nothing without one. That has worked for my wife and I every time. Thats what insurance is for. Once they pay their part, then you can be billed for the rest. They cannot legally charge you for something that they do not know the amount of. My wife and I both worked in healthcare for over 35 years each.
One thing that has caused most of this is the deals that hospitals have made with insurance companies. It is disgusting what hospitals, physicians, laboratories, imaging services, and most other departments get paid by insurance. A physician may charge the insurance company $250 for some procedure. The insurance company only reimburses the physician $8.50 because of the deal made between the insurance company and the hospital or physician group or whoever. Or maybe they pay $3 for that $150 X-ray. That is why everyone in healthcare has to do 10 times the work they used to do because insurance pays almost nothing for services anymore.
I have to get yearly CT scan at mercy that cost me about 1600 with insurance. I say same thing then file for financial assistance. They always knock off another 50% or so
They want you to make a deposit on your bill before your surgery? Is this a thing now? I've never heard of this.
It's a thing, Mercy does this too. They want you to pay for what they estimate your insurance won't cover.
OP should contact Cox's Patient Assistance Program and check with their insurance company about what will be covered.
My wife just had surgery last month at mercy and we didn’t pay anything upfront. Is this very new or for only select surgeries?
A number of times I've had Mercy ask for money before a procedure, in the beginning I would pay, then I'd find that Medicare had paid in full but I never got a refund. Once I started telling them I wouldn't pay until I had a bill and notice from my insurance it's been ok and I've not been refused for any procedures.
Yeah I guess it is. I haven't either to be honest. I'm in good standing with Cox too. I just got a call informing me if I don't pay by the 7th my surgery will have to be rescheduled or canceled. Pretty dumb.
That sounds crazy that they want you to prepay or cancel! They will try bullying you into some form of payment (some employees are worse than others.) The only way I can see this happening is if it’s an elective procedure, ie. plastic surgery of any kind that will probably not be covered by insurance. Even with that, they allow payment plans. Keep us updated after you talk with patient financial services. I hope it all works out for you.
Thank you. It is crazy isn't it? It's not a major surgery but it is a needed surgery. My insurance already approved it. I never thought I would have this much trouble.
What? Rescheduled or cancelled? Can they do that?
They do this for scheduled baby deliverys as well. Went through having to pay 3k+ up front, even though it was all reimbursed by insurance after the fact. Kind of a backwards system.
Probably they want to cover incidentals or unforeseen events that aren't covered. Instead of hounding you for the cash they think they deserve they already have it to withhold from you.
Thanks, I hate it. What an insanely predatory system. I'm glad you got reimbursed and sorry you had to go through that.
I didn't think so but it was a call from the office of the surgeon directly. I'm glad I'm not the only one who thinks this is a bit wild.
Is your surgeon going to offer some assurance as to the outcome of the surgery? I'm guessing not.
I super hate our health care system.
Of course not. I super do too. I worked in Healthcare for years and never heard of this.
Do you have insurance?
It seems like this is more common now. I had my son 7 years ago and never had to prepay for anything. Always just waited for the bill after it was settled through insurance.
Had an ultrasound a few weeks back and they required full payment of the estimated amount due when I checked in.
I'm curious. Who estimated the amount due and did they refund any amount you overpaid for this "estimate."
The whole thing just sounds so scammy. Like "Here's what we think you are going to owe us after your insurance (that you pay for) pays us the amount we agreed this procedure will cost. Now you pay this arbitrarily determined difference or we'll wait a few months to remove that funky looking mole."
As I commented above, they made us pay that estimated amount on my husband’s procedure. It was double the correct amount, and it took months to get the refund.
It was figured by Mercy. I haven't received any documents from my insurance yet, but what Mercy sent me was their estimate of what would be due after insurance.
I just can't imagine another business model, besides the mafia, where you just have to pay arbitrary amounts of money to some third party in order not to die.
lol, truth. I had a couple of surgeries through Mercy last year and it all started with an ER visit. We were at a rural ER in Aurora and I kid you not, the door was locked to keep me from leaving until I paid them $1040, and an armed guard was sitting by the checkout lady. I felt like I was being muscled for cash. I handed them my credit card through the window, she ran it, then signaled to buzz the door open. I honestly felt like it was a mob run thing.
What the shit?! They can’t do that!
You have to have a down payment to buy a car. What’s the big deal about paying a down payment for your surgery?
But I know the price of the car, what it looks like, how it works and the dealer doesn’t sue me the minute I drive it off the lot. I can choose my car dealer. My car insurance company doesn’t dictate the type and model of car I need. I’ve also never had to purchase a car or be permanently disabled. I’ve never been given a car and then told I have to pay for it in ten days or risk losing my house. No car dealer has ever told me I was buying a Kia and then given me a Porsche and expected me to pay the difference. Our medical billing system is arbitrary and predatory. Buying a car is not.
You can shop around for healthcare too. As far as a life threatening surgery, hospitals do those all day long and most of those don’t pay. Somebody has to pay the bill or the hospital will close and then you’ll have no healthcare.
Are you kidding? You can’t really be comparing healthcare to a car. Nobody dies because they couldn’t buy a new car.
I already explained life threatening conditions and how hospitals treat them in the first response. The OP stated a minor outpatient procedure.
Edit: Grammar
Pretty boomer take mate. Not even remotely the same thing, you really don't have a ton of options with how insurance is currently. Regardless of the procedure it's in no way shape or form like owning a car. We could easily turn to socialist medicine which objectively works if we would shed our other corrupt as fuck systems. I even have pretty good insurance through my employer. This absolutely feels like muscling money out of people who need help.
Well just having insurance will reduce your bill, because the hospital negotiates with the payer. It’s the people that don’t have insurance and don’t have an insurance company negotiating on their behalf that you should be concerned about.
Yeah I thought so too, but they've informed me that this is what they assume I'll owe after the insurance. I even have a good standing with them and am a regular patient. They have no real reason to pressure me like this.
I'm sad this is occurring at all. I wish we had a first world health system like the other industrialized nations. But sadly we do not.
1000% agree. Too much money to be made from lobbyists clearly.
All the extra middle men wanting their cut of the pie.
Try getting care in Germany. Pretty bad experience in Stuttgart, a place with a large US military population. Big part of the reason we came back to SGF. These stories aside, my experience at Mercy and the VA clinic in SGF has been a relative joy vs. Germany. And their system is not single payer, either. Lots of cash for services, much more than here, as well as private insurance and hospital horror stories.
Not my experience at all when using non-mil health systems in the EU (or Japan). Maybe they just like Navy guy's better?
I was a civilian (retiree, GS).
Cox is the worst demanding money. You DO NOT have to pay up front. Don’t let them talk you into it. Get on a payment plan after surgery. Keep track of every payment as well.
Thank you a ton! They sure were pushy about it.
I was a Cox employee for a long time. Their billing department is absolutely atrocious. My dad had an ER visit and was brought in by EMS after they thought he had a stroke, he had to go home in paper scrubs obviously didn’t bring his wallet and they asked for $500 before his discharge.
They will want you to either pay upfront in cash or credit card, or get on a payment plan with them. I'd suggest calling Cox back and asking them what options they have for financing.
Healthcare in the United States is a dumpster fire, so I wish you all the best.
Thank you! I'm doing this now!
I’m having surgery coming up too. They did this to me as well, I said nope not happening. I will set up a payment plan after the surgery. They said ok
Very much appreciate your reply. Yours and the other comments have made me feel a lot more confident in telling them to gtfo
Yeah I’ve lost all respect for Cox. I had a pretty significant payment plan with them a few years ago and they insisted I set up auto pay. Apparently they switched over software and shut off the auto pay but did not notify me. I didn’t figure it out until I started getting collections calls. From now on they will send me a monthly bill.
I used to work outpatient registration at Cox and pre payment is on fact a thing. However, you don’t need to pay anything up front if you’re not able to. They won’t turn you away or anything. I’m like you, I always wait for insurance to do it’s thing first.9
Seems like the thing to do. I hope they won't, I've put off the surgery for a year already because they did this last time.
They (Cox) wouldn't do a preventative procedure (colonoscopy) that is totally covered by insurance unless $2,000.00 was paid first. They said pay or we'll cancel the procedure. We didn't pay. The procedure was cancelled. Never heard from them again.
A friend of mine just went through this. She was told she had to pay so much upfront or it would be rescheduled. If your surgery isn’t “important” then they will push it back. It’s honestly mind blowing to me.
Wow that's insane. Mind blowing is a good way to put it. I don't know why anybody pays for this or insurance if they offer no help.
Honestly I hate the health care/hospital here. I’d rather go up to KC or St. Louis honestly :/
That might end up being what I have to do. If that's the case I'll be sure to let them know that their lack of financing or willingness to work with me led them to make absolutely nothing off me or my insurance.
So to add to this i will say it depends entirely on the doctor and procedure. The people who call for payment up front shouldnt be using such strong language of it being cancelled and its up to the whims of the doctors. I know a few of the ones who are making the collection calls and they arent a fan of it either.
But to elaborate at least for the doctor portion, some doctors themselves require the estimate portion of theirs up front and will cancel or move a surgery on you until you are able to do so. It also depends on the seriousness of the procedure. A cancer related procedure, i dont know a single doctor who would reschedule unless they were dying. A non-urgent gallbladder removal, some doctors will still do it, some will require that payment. If the procedure is considered elective or cosmetic, payment will be required up front or you dont get it period. Part of this is Cox policy, part of this is doctors wanting their portion up front because of having too many skip out on their bill.
Other comments also have sound advice in looking into financial assistance.
Also just to let you know, there are three different billing departments. One for the physicians themselves and their portions, one for the hospital facility use itself, and if anesthesia is required for your procedure, there will be a bill from the anesthesiologist too. Each has their own sets of billing procedures to some extent. I really only know of the physician side.
If i were to speculate for the hospital side, there is a chance that if your surgery isnt considered serious enough, they could be requiring that payment for the timeslot up front, and if not paid they would move a more urgebt surgery into that time frame. This is purely speculation as I have little to no idea on that side.
Cox made us pay what they said we would owe after insurance before my husband’s procedure, and after they filed the insurance it turned out their amount was double the correct amount. We eventually got a refund, but it would have been nice to have that extra money for all those months.
Didn’t have that experience. Billed insurance.
Had the same experiences with a couple surgeries at Mercy last year. I don't know how Cox works but at Mercy the surgeon had a separate office that did billing for his services. I was able to talk to them and make arrangements even if the website made it sound like I couldn't. Also you might try applying for a Carecredit credit card. Those are used specifically for doctor and veterinarian visits not covered by insurance and they have pretty good financing terms.
I think that's actually who is pressing me to pay up front lol. I will absolutely look into care credit though.
This is a common thing the financial advisors say however, usually the financial advisors have no relationship with the surgeons and minimal relationship with the surgery schedulers. They have zero control over whether your surgeon actually does your surgery or not, this is just something they say hoping to get payment from you. Which is completely shitty none the less but reassuring that your surgery is not going to be canceled because you can’t pay for it upfront.
Thank you! This was really stressful but I'm seeing more and more of these responses which helps a lot.
i was supposed to have surgery at Cox with insurance and i got there for my surgery and they said i had to pay 1k upfront not including hospital fees to even get started so i had to cancel
I’ve had to prepay for nearly all procedures I’ve had. I’m with Mercy. I’m sorry you’re going through this.
Just to clarify while I did state it is a 'minor outpatient procedure' it is still medically necessary and not an elective procedure. The procedure itself has already been approved by insurance. This is solely a side payment they want from me. I even did offer to make payments and was directly told that isn't available and the cash is needed up front. After reading other comments here I honestly believe this practice should be illegal.
hobbit5687 t1_je61nud wrote
I just had a minor outpatient surgery at Mercy. On the online portal it made it seem like I had to pay prior to the surgery. But when I checked in for the surgery I said I wanted to wait until my insurance processed it so that I knew exactly what I was paying for, rather than just the general estimate given prior to the surgery. You can’t be required to pay upfront but they make it sound like you do. Hope this helps! Hoping for a smooth and quick recovery for you!