Hi, I’m new to US healthcare. Despite having good insurance with low deductibles, I don’t use it much because I don’t trust or understand its billing methods. When I go visit my home country, I just schedule all appointments in advance and make all tests and visits there.
But I know there are some free services included in my plan, I don’t know which exactly, but according to some “affordable care act” I supposed annuals with PC doctor and Gyn might be included.
So, I choose a PC doctor in a huge clinic system and had the very first appointment in January 2021. I told them I’m fine and I just want to be checked up. This visit is listed as “office/outpatient Visit New” with copay + a few bucks for bloodwork. Sounds good to me.
Then I made another appointment with a gynecologist in the same clinic system (but another address) in December 2021. I also told them I’m fine, just check whatever you normally check. I know they had access to my previous records made by PC because they were asking “are you still taking XX supplement?” and “are you allergic to YY?” etc. They did a pap smear, pelvic, and breast exam. That visit was listed as “Prev Visit New Age 18-39” but billed almost in full, the insurance gave only a small discount for using an “in-network” provider. I don’t understand the reason it was not covered and don’t know what I should do in the future to avoid such situations.
Is that because I had like two “annuals” in one year? But they were different, they checked different things. Or the reason in different location of the doctor?
I did contact both the hospital and insurance but their answers take sooo long that I can’t sort it out before the “due date” on the bill. What I should do with this bill? Will there be a fine if I don’t pay it on time? Would that mean that I accept the bill if I pay it?
Thanks in advance for all your replies or suggestions.
submitted by /u/alinaria
[link] [comments]Hi, I’m new to US healthcare. Despite having good insurance with low deductibles, I don’t use it much because I don’t trust or understand its billing methods. When I go visit my home country, I just schedule all appointments in advance and make all tests and visits there. But I know there are some free services included in my plan, I don’t know which exactly, but according to some “affordable care act” I supposed annuals with PC doctor and Gyn might be included. So, I choose a PC doctor in a huge clinic system and had the very first appointment in January 2021. I told them I’m fine and I just want to be checked up. This visit is listed as “office/outpatient Visit New” with copay + a few bucks for bloodwork. Sounds good to me. Then I made another appointment with a gynecologist in the same clinic system (but another address) in December 2021. I also told them I’m fine, just check whatever you normally check. I know they had access to my previous records made by PC because they were asking “are you still taking XX supplement?” and “are you allergic to YY?” etc. They did a pap smear, pelvic, and breast exam. That visit was listed as “Prev Visit New Age 18-39” but billed almost in full, the insurance gave only a small discount for using an “in-network” provider. I don’t understand the reason it was not covered and don’t know what I should do in the future to avoid such situations. Is that because I had like two “annuals” in one year? But they were different, they checked different things. Or the reason in different location of the doctor? I did contact both the hospital and insurance but their answers take sooo long that I can’t sort it out before the “due date” on the bill. What I should do with this bill? Will there be a fine if I don’t pay it on time? Would that mean that I accept the bill if I pay it? Thanks in advance for all your replies or suggestions. submitted by /u/alinaria [link] [comments]Read Morer/HealthInsurance