I had a PRP injection procedure done at the orthopedic surgeon. They told me insurance wouldn’t cover it. I asked them for the code, and then asked the insurance company if it was covered. Insurance company said it was so I advised the surgeon that it was covered and I wanted to go ahead with the procedure. They verbally told me that if the insurance wouldn’t pay, then I would have to pay out of pocket. I wasn’t aware that the provider has contract with my insurance company that they will not accept payment for PRP injection. I don’t know why they would have a contract with the insurance company and not accept payment for this procedure other than that they are able to convince their patients to pay out of pocket and get paid much more. I feel obligated to pay them for the procedure because they did their best to advise me that it wasn’t covered before receiving the injection. (actually if they did their best they should have been able to explain before the procedure that “we have a contract with the insurance company that does not allow them to pay us for the procedure even if it is allowed in your plan and therefore we ask you to pay for it”). Seems like as soon as you know a little bit about insurance you only know enough to get your hands dirty.
submitted by /u/j0shuascott
[link] [comments]I had a PRP injection procedure done at the orthopedic surgeon. They told me insurance wouldn’t cover it. I asked them for the code, and then asked the insurance company if it was covered. Insurance company said it was so I advised the surgeon that it was covered and I wanted to go ahead with the procedure. They verbally told me that if the insurance wouldn’t pay, then I would have to pay out of pocket. I wasn’t aware that the provider has contract with my insurance company that they will not accept payment for PRP injection. I don’t know why they would have a contract with the insurance company and not accept payment for this procedure other than that they are able to convince their patients to pay out of pocket and get paid much more. I feel obligated to pay them for the procedure because they did their best to advise me that it wasn’t covered before receiving the injection. (actually if they did their best they should have been able to explain before the procedure that “we have a contract with the insurance company that does not allow them to pay us for the procedure even if it is allowed in your plan and therefore we ask you to pay for it”). Seems like as soon as you know a little bit about insurance you only know enough to get your hands dirty. submitted by /u/j0shuascott [link] [comments]Read Morer/HealthInsurance