Doctor’s Office Gave Me A Discount And Took It Back

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I’ve met my deductible. Now I’ve to pay 30% until I meet my OOP max. So far this was the process:

  1. Doctor sends a summary of charge:
    1. Total bill: $3,000
    2. Payment/Adjustment: 0
    3. Total Due: 0
  2. After Insurance accepts the claim, my explanation of benefits is:
    1. Total bill: $3,000
    2. Insurance member discount: $1,000
    3. Insurance pays: $1,400
    4. Amount I owe: $600
  3. Doctor send me a bill for $600 which is 30% of my coinsurance (after insurance discount)

However, on a recent doctor visit for a $3,000 total bill, they mentioned – $2,000 in the Payment/Adjustment section of the summary of charge. So I was expecting them to file a claim for only $1,000. They did not. They claimed the total bill of $3,000. I called the doctor’s office. The call center representative said that they initially gave me a discount and they took the discount back. He can’t share the reason for this. He is saying this is because of the proprietary deal they have with the insurance companies. I wanted to know why they gave me a discount in the first place. He can’t say why. After consulting with his manager he says that no one will be able to give me an answer for this.

Does anyone else know what is going on? I’m not complaining because I’m paying what I had to pay per my insurance. I’m just curious about what happened, why the doctor’s office gave me a discount and then took it away. This has never happened in the last couple of years.

submitted by /u/throwaway_hidnFrmFrn
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I’ve met my deductible. Now I’ve to pay 30% until I meet my OOP max. So far this was the process:
Doctor sends a summary of charge:
Total bill: $3,000 Payment/Adjustment: 0 Total Due: 0
After Insurance accepts the claim, my explanation of benefits is:
Total bill: $3,000 Insurance member discount: $1,000 Insurance pays: $1,400 Amount I owe: $600
Doctor send me a bill for $600 which is 30% of my coinsurance (after insurance discount)
However, on a recent doctor visit for a $3,000 total bill, they mentioned – $2,000 in the Payment/Adjustment section of the summary of charge. So I was expecting them to file a claim for only $1,000. They did not. They claimed the total bill of $3,000. I called the doctor’s office. The call center representative said that they initially gave me a discount and they took the discount back. He can’t share the reason for this. He is saying this is because of the proprietary deal they have with the insurance companies. I wanted to know why they gave me a discount in the first place. He can’t say why. After consulting with his manager he says that no one will be able to give me an answer for this. Does anyone else know what is going on? I’m not complaining because I’m paying what I had to pay per my insurance. I’m just curious about what happened, why the doctor’s office gave me a discount and then took it away. This has never happened in the last couple of years.
submitted by /u/throwaway_hidnFrmFrn [link] [comments]Read Morer/HealthInsurance

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