Hi there,
I think I just made an incredibly expensive mistake. I found a new Gynecologist on Zocdoc, who was listed as in network on that site. But like an idiot, I didn’t double check that information with my provider before I went in for a check up.
At my visit, I received a routine check up, pap smear, and a pelvic ultrasound. When I checked my insurance portal a few weeks later, six different claims had been submitted for this visit. The first two suggested that I owed nothing out of pocket for the visit. These claims were denied, and four additional claims for the same services were submitted, two more of which were denied, but two were accepted. With the two accepted claims, I owe over $10,000 dollars. And, as you might have guessed, the Gynecologist is actually out of my network.
I called up Anthem, my provider, to figure out if there was some kind of mistake. The woman on the phone was really helpful, and suggested that the gynecologist might be trying to charge me twice for bundled and un bundled services. She also noted that since I didn’t realize the office was out of network, she would submit a request to adjust the cost to in network, under NY surprise billing laws.
My question is: am I stupid to wait on the insurance company to hopefully mitigate this huge price tag? Or should I go directly to the gynecologist to try and negotiate down my bill?
My fear in negotiating with the doctor is that I potentially might have to pay more than if the insurance company allows me to pay as though the doctor was in network. But the choice to go to this place was technically my fault, so I’m also a little nervous the insurance company will rule against me.
What should I do?
Additional ramble:
The messy claims submission makes me wonder if there is some kind of mistake from the doctor’s billing department? $10,000 seems outrageous for the services I received, but I know that they were probably just trying to get what they could from the insurance company…..
submitted by /u/moonpetals
[link] [comments]
Hi there, I think I just made an incredibly expensive mistake. I found a new Gynecologist on Zocdoc, who was listed as in network on that site. But like an idiot, I didn’t double check that information with my provider before I went in for a check up. At my visit, I received a routine check up, pap smear, and a pelvic ultrasound. When I checked my insurance portal a few weeks later, six different claims had been submitted for this visit. The first two suggested that I owed nothing out of pocket for the visit. These claims were denied, and four additional claims for the same services were submitted, two more of which were denied, but two were accepted. With the two accepted claims, I owe over $10,000 dollars. And, as you might have guessed, the Gynecologist is actually out of my network. I called up Anthem, my provider, to figure out if there was some kind of mistake. The woman on the phone was really helpful, and suggested that the gynecologist might be trying to charge me twice for bundled and un bundled services. She also noted that since I didn’t realize the office was out of network, she would submit a request to adjust the cost to in network, under NY surprise billing laws. My question is: am I stupid to wait on the insurance company to hopefully mitigate this huge price tag? Or should I go directly to the gynecologist to try and negotiate down my bill? My fear in negotiating with the doctor is that I potentially might have to pay more than if the insurance company allows me to pay as though the doctor was in network. But the choice to go to this place was technically my fault, so I’m also a little nervous the insurance company will rule against me. What should I do? Additional ramble: The messy claims submission makes me wonder if there is some kind of mistake from the doctor’s billing department? $10,000 seems outrageous for the services I received, but I know that they were probably just trying to get what they could from the insurance company…..
submitted by /u/moonpetals [link] [comments]Read Morer/HealthInsurance