I went on the BCBS website to see if the claims for a hospital procedure I had a few weeks ago had been processed yet. They haven’t, its all still pending. But, the amount left on my out-of-pocket max is a few hundred dollars lower now. I noticed that this happened earlier before my procedure as well. There was $581 left about a month ago, then just after my procedure but before any of the claims had appeared it was down to $390 and now today its down to $230. There is nearly a $500 discrepancy now between what I’ve actually paid (and they have listed as “your part”) and what they say I have left to pay out-of-pocket. I checked last year just to see and there was also a discrepancy in the same direction then, but it was only $80. Just to make things clear my out-of-pocket max is $2000, what is left is apparently $230 and “your part” aka what I’ve actually paid this year is $1,275. I met my deductible ($400) long ago.
In the time its lowered from $581 to $230 I haven’t paid any medical bills and all of the new claims are still listed as “processing” without any indication of how much I will end up paying. Importantly, I am expecting that this whole hospital procedure will have cost more than $581 and have caused me to meet my out-of-pocket max.
Normally, I’d just call up BCBS and ask what is going on, but I don’t want to point out that they are saying I owe less money than I think I should. Any explanation as to what is going on? Are they applying amounts that I’ll have to pay for this procedure already even though they aren’t listing what my part is yet? Or is something magical happening and I’ll only owe $230 for this procedure instead of $581?
submitted by /u/archaeob
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I went on the BCBS website to see if the claims for a hospital procedure I had a few weeks ago had been processed yet. They haven’t, its all still pending. But, the amount left on my out-of-pocket max is a few hundred dollars lower now. I noticed that this happened earlier before my procedure as well. There was $581 left about a month ago, then just after my procedure but before any of the claims had appeared it was down to $390 and now today its down to $230. There is nearly a $500 discrepancy now between what I’ve actually paid (and they have listed as “your part”) and what they say I have left to pay out-of-pocket. I checked last year just to see and there was also a discrepancy in the same direction then, but it was only $80. Just to make things clear my out-of-pocket max is $2000, what is left is apparently $230 and “your part” aka what I’ve actually paid this year is $1,275. I met my deductible ($400) long ago. In the time its lowered from $581 to $230 I haven’t paid any medical bills and all of the new claims are still listed as “processing” without any indication of how much I will end up paying. Importantly, I am expecting that this whole hospital procedure will have cost more than $581 and have caused me to meet my out-of-pocket max. Normally, I’d just call up BCBS and ask what is going on, but I don’t want to point out that they are saying I owe less money than I think I should. Any explanation as to what is going on? Are they applying amounts that I’ll have to pay for this procedure already even though they aren’t listing what my part is yet? Or is something magical happening and I’ll only owe $230 for this procedure instead of $581?
submitted by /u/archaeob [link] [comments]Read Morer/HealthInsurance