The doc orders a DEXA because osteopenia. Despite the diagnosis, insurance denies auth, saying I have to be older and female.
Not in the mood to argue with insurance or to make my busy doc’s office do it, I stop by SimonMed to ask about it. They tell me they’ll do the DEXA for $50 cash up-front. I paid and scheduled the DEXA.
On DEXA day though, they gave me a receipt that says something like “this is a preliminary balance that may change depending on blah blah blah.”
I told the receptionist that I was quoted a cash prepay amount that I already paid and I would not accept a receipt that was basically an open ended bill. She of course was flustered and didn’t know what to do.
I asked her to write, “Patient paid bill in full on [date].” She went to somebody in the back office to get permission, then she wrote the message and her name on my receipt.
The deal here is this: My insurance copay for all radiology services, from DEXA to lung x-ray to brain MRI w/contrast, is $120. At this time my insurance has not approved this procedure.
I expect to get a bill from SimonMed for $70 sometime soon. Does anyone here have better knowledge than I about how to handle this? Thanks.
Location is AZ, USA. Insurance is a Medicare Advantage plan.
submitted by /u/ChucklesManson
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The doc orders a DEXA because osteopenia. Despite the diagnosis, insurance denies auth, saying I have to be older and female. Not in the mood to argue with insurance or to make my busy doc’s office do it, I stop by SimonMed to ask about it. They tell me they’ll do the DEXA for $50 cash up-front. I paid and scheduled the DEXA. On DEXA day though, they gave me a receipt that says something like “this is a preliminary balance that may change depending on blah blah blah.” I told the receptionist that I was quoted a cash prepay amount that I already paid and I would not accept a receipt that was basically an open ended bill. She of course was flustered and didn’t know what to do. I asked her to write, “Patient paid bill in full on [date].” She went to somebody in the back office to get permission, then she wrote the message and her name on my receipt. The deal here is this: My insurance copay for all radiology services, from DEXA to lung x-ray to brain MRI w/contrast, is $120. At this time my insurance has not approved this procedure. I expect to get a bill from SimonMed for $70 sometime soon. Does anyone here have better knowledge than I about how to handle this? Thanks. Location is AZ, USA. Insurance is a Medicare Advantage plan.
submitted by /u/ChucklesManson [link] [comments]Read Morer/HealthInsurance