I currently have GEHA standard as my health insurance provider. I started to feel pain after a regular workout at the gym and went to a chiropractor. Time went on and started to feel sciatica on my right leg and did not feel an improvement. I went to Greater Pain center here in TX, doctor had me get a lumbar MRI. I was told that insurance does not process electronically with them and that they would send the full bill to my insurance. At that specific time I had not met my 300 dollar deductible. Never heard anything from ARA or GEHA regarding payment. The doctor revived the results and I have a L5-S1 herniated disk and was told I would be receiving cortisone shots. I went to receive my first shot and was charged the full amount since I had not met me deductible. Now today I receive paperwork from my insurance on the top it reads it’s not a bill but it has a breakdown of the MRI costs. Amount billed 1200 Amount allowed 699.52 Claim disallow 500.48 Other coverage payment 0 GEHA total paid 297.09 Member responsibility 402.43
Does this mean I have to pay 402.43 even after I already met my deductible when I paid in full for my first cortisone shot? My plan states it’s 15% coinsurance on MRI’s. Im confused on what’s going on here.
submitted by /u/IzaguirreC
[link] [comments]I currently have GEHA standard as my health insurance provider. I started to feel pain after a regular workout at the gym and went to a chiropractor. Time went on and started to feel sciatica on my right leg and did not feel an improvement. I went to Greater Pain center here in TX, doctor had me get a lumbar MRI. I was told that insurance does not process electronically with them and that they would send the full bill to my insurance. At that specific time I had not met my 300 dollar deductible. Never heard anything from ARA or GEHA regarding payment. The doctor revived the results and I have a L5-S1 herniated disk and was told I would be receiving cortisone shots. I went to receive my first shot and was charged the full amount since I had not met me deductible. Now today I receive paperwork from my insurance on the top it reads it’s not a bill but it has a breakdown of the MRI costs. Amount billed 1200 Amount allowed 699.52 Claim disallow 500.48 Other coverage payment 0 GEHA total paid 297.09 Member responsibility 402.43 Does this mean I have to pay 402.43 even after I already met my deductible when I paid in full for my first cortisone shot? My plan states it’s 15% coinsurance on MRI’s. Im confused on what’s going on here. submitted by /u/IzaguirreC [link] [comments]Read Morer/HealthInsurance