It’s been a year. We’ve billed the insurance close to $90,000. Right now, they are saying “We May Owe” $15,000. Most of this is incorrect stuff or stuff we’ve paid up (like it hasn’t processed copays for some prescriptions)
But one charge is scaring us. They paid $9k to the ENT for surgery, and said “We May Owe” an additional SIX THOUSAND DOLLARS. We were told beforehand everything was covered 100% EXCEPT for 10% of the HOSPITAL costs. Furthermore our OOP maximum is only $4k. How on earth can we be stuck with a bill more than our “out of pocket maximum” and why would they pay a little more than half of this bill after previously telling us it was covered?
We budgeted for meeting our OOP maximum at $4k. We didn’t budget for $6.5k and don’t have it; but we haven’t received a bill. This is just on the online portal under “you may owe”. So do we need to worry????
This was all in network, we were told no prior authorization was needed, and there is “no explanation of benefits available at this time”. We also met our deductible ages ago, if it matters.
submitted by /u/Ravioli_meatball19
[link] [comments]It’s been a year. We’ve billed the insurance close to $90,000. Right now, they are saying “We May Owe” $15,000. Most of this is incorrect stuff or stuff we’ve paid up (like it hasn’t processed copays for some prescriptions) But one charge is scaring us. They paid $9k to the ENT for surgery, and said “We May Owe” an additional SIX THOUSAND DOLLARS. We were told beforehand everything was covered 100% EXCEPT for 10% of the HOSPITAL costs. Furthermore our OOP maximum is only $4k. How on earth can we be stuck with a bill more than our “out of pocket maximum” and why would they pay a little more than half of this bill after previously telling us it was covered? We budgeted for meeting our OOP maximum at $4k. We didn’t budget for $6.5k and don’t have it; but we haven’t received a bill. This is just on the online portal under “you may owe”. So do we need to worry???? This was all in network, we were told no prior authorization was needed, and there is “no explanation of benefits available at this time”. We also met our deductible ages ago, if it matters. submitted by /u/Ravioli_meatball19 [link] [comments]Read Morer/HealthInsurance