Had Eye Surgery last year. Doctor told me cost was 7500/eye. (15k total). Doctor stated that they have been screwed by insurance in the past and require a $5000/eye (10K) and that once insurance pays they will give me my deposit back.
I called my insurance 3 different times to confirm that my doctor was in network and was told it mostly like would be a co pay per eye (you cant do both eyes the same day) or at most it would be my out of pocket maximum of $1500.
Doctor had a private company call my insurance and confirm my coverage. The company stated: Will be covered 100% of contracted rate after copay or possible 1500 out of pocket max. No Authorization required provider can buy and bill.
When I did the procedure they had me sign paperwork that stated if my insurance did not pay for service i would be responsible. I signed, payed the deposit and got my procedure.
Insurance determined it was covered 100% I just owed by $60 copays.
Doctor said insurance only paid the contract agreed amount of $2500/eye so I still owe $5000/eye.
This doesn’t seem right anyone have any experience what I should do. I put a complaint for review from my insurance company.
submitted by /u/MattsRod
[link] [comments]
Had Eye Surgery last year. Doctor told me cost was 7500/eye. (15k total). Doctor stated that they have been screwed by insurance in the past and require a $5000/eye (10K) and that once insurance pays they will give me my deposit back. I called my insurance 3 different times to confirm that my doctor was in network and was told it mostly like would be a co pay per eye (you cant do both eyes the same day) or at most it would be my out of pocket maximum of $1500. Doctor had a private company call my insurance and confirm my coverage. The company stated: Will be covered 100% of contracted rate after copay or possible 1500 out of pocket max. No Authorization required provider can buy and bill. When I did the procedure they had me sign paperwork that stated if my insurance did not pay for service i would be responsible. I signed, payed the deposit and got my procedure. Insurance determined it was covered 100% I just owed by $60 copays. Doctor said insurance only paid the contract agreed amount of $2500/eye so I still owe $5000/eye. This doesn’t seem right anyone have any experience what I should do. I put a complaint for review from my insurance company.
submitted by /u/MattsRod [link] [comments]Read Morer/HealthInsurance