Suddenly owe $455 when I was told it would only be a $20 Copay?

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Last week I went for psychological testing. It was a 3 hour appointment. About one week before the appointment, the psychologist took my insurance information and said that I should just owe her a $20 Copay (I have a BCBS PPO) . It is now a week after the appointment and I received an email from the psychologist telling me that I now owe $455 because my insurance didn’t process it with a copay of $20 and instead put it toward my deductible (which is $435). I have spent the last two hours losing my mind trying to figure out how this happened because I really don’t have the money for this right now… especially since I need to have one or two more appointments to receive my final diagnosis. I can’t speak to anyone at my insurance until Monday as they are closed, and I don’t really want to ask my dad about this as he doesn’t know I went in for psychological testing…

Is this possibly an error on BCBS’s part? In the email I just received, the doctor said in her email: “I’m just letting you knowbecause this is different from what you and I had previously discussed and, unfortunately, insurance is allowed to change policies whenever they like (that I am not privy to!). I’m attaching your billing statement and also the claim details in case you want to call them yourself. On my end, there is nothing I can do to change the cost.”

FROM / TO PROC AMOUNT AMOUNT OVER**** DEDUCTIONS/OTHER SERVICES DATES PS** PAY CODE BILLED PAID MAX ALLOW INELIGIBLE NOT COVERED 02/19-02/19/21 03 PPO 90791 250.00 0.00 70.72 179.28 ( 2) 0.00 02/19-02/19/21 03 PPO 96130 250.00 0.00 88.54 161.46 ( 2) 0.00 02/19-02/19/21 03 PPO 96131 1250.00 635.90 499.84 114.26 ( 2) 0.00 02/19-02/19/21 03 PPO 96136 250.00 63.95 186.05 0.00 0.00 02/19-02/19/21 03 PPO 96137 600.00 350.52 249.48 0.00 0.00 + __________ __________ __________ __________ __________ 2600.00 1050.37 1094.63 455.00 0.00 0 AMOUNT PAID TO PROVIDER FOR THIS CLAIM: $1,050.37 CONTRACT DEDUCTIBLE: 455.00 + _____________ DEDUCTIONS/OTHER INELIGIBLE: $455.00 + _____________ PATIENT’S SHARE: $455.00

I looked up the pay codes and found something that looked weird to me. 96130 is supposed to be for the first hour and 96131 for the second hour… but 96131 is $1250 vs the $250 for the first hour… is it normal to charge $1000 more per hour?

Also is it normal that I am still being charged the copay with my deductible?

Perhaps that is normal, but maybe you notice something else wrong with this? I apologize if this is a stupid question and it’s obvious that I owe the money. I just wasn’t expecting to owe this much and it makes me sick to my stomach thinking about paying this money and then it going to waste because I won’t even have any money to go back and get my official diagnosis to start treatment. Thank you in advance for your help.

submitted by /u/Cavely88
[link] [comments]
Last week I went for psychological testing. It was a 3 hour appointment. About one week before the appointment, the psychologist took my insurance information and said that I should just owe her a $20 Copay (I have a BCBS PPO) . It is now a week after the appointment and I received an email from the psychologist telling me that I now owe $455 because my insurance didn’t process it with a copay of $20 and instead put it toward my deductible (which is $435). I have spent the last two hours losing my mind trying to figure out how this happened because I really don’t have the money for this right now… especially since I need to have one or two more appointments to receive my final diagnosis. I can’t speak to anyone at my insurance until Monday as they are closed, and I don’t really want to ask my dad about this as he doesn’t know I went in for psychological testing… Is this possibly an error on BCBS’s part? In the email I just received, the doctor said in her email: “I’m just letting you knowbecause this is different from what you and I had previously discussed and, unfortunately, insurance is allowed to change policies whenever they like (that I am not privy to!). I’m attaching your billing statement and also the claim details in case you want to call them yourself. On my end, there is nothing I can do to change the cost.” FROM / TO PROC AMOUNT AMOUNT OVER**** DEDUCTIONS/OTHER SERVICES DATES PS** PAY CODE BILLED PAID MAX ALLOW INELIGIBLE NOT COVERED 02/19-02/19/21 03 PPO 90791 250.00 0.00 70.72 179.28 ( 2) 0.00 02/19-02/19/21 03 PPO 96130 250.00 0.00 88.54 161.46 ( 2) 0.00 02/19-02/19/21 03 PPO 96131 1250.00 635.90 499.84 114.26 ( 2) 0.00 02/19-02/19/21 03 PPO 96136 250.00 63.95 186.05 0.00 0.00 02/19-02/19/21 03 PPO 96137 600.00 350.52 249.48 0.00 0.00 + __________ __________ __________ __________ __________ 2600.00 1050.37 1094.63 455.00 0.00 0 AMOUNT PAID TO PROVIDER FOR THIS CLAIM: $1,050.37 CONTRACT DEDUCTIBLE: 455.00 + _____________ DEDUCTIONS/OTHER INELIGIBLE: $455.00 + _____________ PATIENT’S SHARE: $455.00 I looked up the pay codes and found something that looked weird to me. 96130 is supposed to be for the first hour and 96131 for the second hour… but 96131 is $1250 vs the $250 for the first hour… is it normal to charge $1000 more per hour? Also is it normal that I am still being charged the copay with my deductible? Perhaps that is normal, but maybe you notice something else wrong with this? I apologize if this is a stupid question and it’s obvious that I owe the money. I just wasn’t expecting to owe this much and it makes me sick to my stomach thinking about paying this money and then it going to waste because I won’t even have any money to go back and get my official diagnosis to start treatment. Thank you in advance for your help.
submitted by /u/Cavely88 [link] [comments]Read Morer/HealthInsurance

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