I started allergy shots a few months ago. Before the clinic made the serum/antigens, they wanted me to verify insurance coverage and provided me with CPT codes. I called my insurance and they said “yes, they’re covered.” The clinic then made me sign an agreement to purchase a year’s worth of shots, saying anything not covered by insurance would be patient responsibility. I signed because I thought it would be covered based on my convo w/ insurance.
Fast forward, I suddenly receive a bill for hundreds and hundreds of dollars. Insurance stopped covering the serum after a certain date. I called the clinic and they said “well, you signed an agreement to pay.” I said I did so with the understanding that it would be covered and I cannot pay this. They basically said, tough luck.
Next, I called my insurance company and they said at the time of billing, they alerted my provider that they were going to hit their limit of how many times per year they could bill that CPT code, and they still billed it anyway. (I wasn’t made aware of this limit in my initial call with insurance, nor did the clinic tell me the amount they were going to make.) Ins. called my provider and they said “she signed an agreement.”
Does this agreement really hold weight? I feel like I got blindsided and wasn’t properly informed or given the option/choice to proceed when they knew they would go beyond my coverage.
submitted by /u/the_hummingbird_
[link] [comments]I started allergy shots a few months ago. Before the clinic made the serum/antigens, they wanted me to verify insurance coverage and provided me with CPT codes. I called my insurance and they said “yes, they’re covered.” The clinic then made me sign an agreement to purchase a year’s worth of shots, saying anything not covered by insurance would be patient responsibility. I signed because I thought it would be covered based on my convo w/ insurance. Fast forward, I suddenly receive a bill for hundreds and hundreds of dollars. Insurance stopped covering the serum after a certain date. I called the clinic and they said “well, you signed an agreement to pay.” I said I did so with the understanding that it would be covered and I cannot pay this. They basically said, tough luck. Next, I called my insurance company and they said at the time of billing, they alerted my provider that they were going to hit their limit of how many times per year they could bill that CPT code, and they still billed it anyway. (I wasn’t made aware of this limit in my initial call with insurance, nor did the clinic tell me the amount they were going to make.) Ins. called my provider and they said “she signed an agreement.” Does this agreement really hold weight? I feel like I got blindsided and wasn’t properly informed or given the option/choice to proceed when they knew they would go beyond my coverage. submitted by /u/the_hummingbird_ [link] [comments]Read Morer/HealthInsurance