Hey all, I hope someone can give me a piece of advice on an issue I have with my insurance. A couple of months ago I had a procedure in a hospital and they charged $2,450 (amount billed). However, the insurance company’s EOB shows $4,812.76 (allowed amount). I have paid my deductible and I have a coinsurance of 10%, so the hospital is charging me $481.28 instead of $245.
I called the hospital and they won’t adjust anything since they just follow the amounts on the insurance claim. I called the insurance company and they say they have a “contract” with the provider that forces them to pay the allowed amount, not the amount billed, so they’re claiming they can’t make any adjustment. Is that even legal? Has somebody experienced/heard of a situation like that?
I’m in NYC, the insurance provider is Cigna.
Thank you in advance.
submitted by /u/spycyn69
[link] [comments]Hey all, I hope someone can give me a piece of advice on an issue I have with my insurance. A couple of months ago I had a procedure in a hospital and they charged $2,450 (amount billed). However, the insurance company’s EOB shows $4,812.76 (allowed amount). I have paid my deductible and I have a coinsurance of 10%, so the hospital is charging me $481.28 instead of $245. I called the hospital and they won’t adjust anything since they just follow the amounts on the insurance claim. I called the insurance company and they say they have a “contract” with the provider that forces them to pay the allowed amount, not the amount billed, so they’re claiming they can’t make any adjustment. Is that even legal? Has somebody experienced/heard of a situation like that? I’m in NYC, the insurance provider is Cigna. Thank you in advance. submitted by /u/spycyn69 [link] [comments]Read Morer/HealthInsurance