I aged off of my moms insurance after my procedure a few months ago. I was concerned about post op visits, knowing my doctor only took my old insurance and doesn’t take United (well, he technically takes United but not the Community Plan). I was told all post op visits for the procedure would be billed under the old plan and covered as long as it pertained to that procedure. Today I got a bill from the doctor for the CT scan. $400 balance billed, no contracted rate I guess, but my EOB on United says that it’s not covered. I looked at my plan documents and it appears CBCT’s might require pre authorization?
Am I on the hook for the $400? Or do you think either: A) maybe the charge was unintentional and I can get the doctor to remove the charge altogether since it should’ve been included with post op stuff or B) there is any chance that United will still cover it even though I didn’t submit a preauthorization for it the scan to be done?
Worst case scenario, I guess I just owe the $400, but I like to do my due diligence because it seems unfair to have to pay for it just because the procedure and such was covered under a difference insurance plan.
submitted by /u/itsconnorbro
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I aged off of my moms insurance after my procedure a few months ago. I was concerned about post op visits, knowing my doctor only took my old insurance and doesn’t take United (well, he technically takes United but not the Community Plan). I was told all post op visits for the procedure would be billed under the old plan and covered as long as it pertained to that procedure. Today I got a bill from the doctor for the CT scan. $400 balance billed, no contracted rate I guess, but my EOB on United says that it’s not covered. I looked at my plan documents and it appears CBCT’s might require pre authorization? Am I on the hook for the $400? Or do you think either: A) maybe the charge was unintentional and I can get the doctor to remove the charge altogether since it should’ve been included with post op stuff or B) there is any chance that United will still cover it even though I didn’t submit a preauthorization for it the scan to be done? Worst case scenario, I guess I just owe the $400, but I like to do my due diligence because it seems unfair to have to pay for it just because the procedure and such was covered under a difference insurance plan.
submitted by /u/itsconnorbro [link] [comments]Read Morer/HealthInsurance