Hey all,
I’m in Maryland, with employer-sponsored UnitedHealthCare insurance on a PPO plan. I went to an ER in a hospital which UHC lists as in-network. I received two bills (one from the hospital, one from the physician’s group), and UHC explains that it’s because they covered the physician at the in-network rate even though they are out-of-network, and that this is not a balance bill and that I am on the hook for the difference. The physicians group said I can write them a letter requesting they reduce the bill, but that they don’t participate in UHC’s network. This physicians group seems to have exclusive privileges to work in that ER.
I’ve read these:
https://www.commonwealthfund.org/blog/2019/state-efforts-protect-consumers-balance-billing
https://www.marylandattorneygeneral.gov/Pages/CPD/Tips-Publications/tip41.aspx
https://insurance.maryland.gov/Consumer/Documents/publications/AssignmentofBenefitsFAQ.pdf
Am I really on the hook for this? It seems like a prohibited balance bill to me, and I haven’t heard any rationale as to why it’s not. How do I prevent this from happening in the future?
Thanks!
submitted by /u/erbillta8675309
[link] [comments]
Hey all, I’m in Maryland, with employer-sponsored UnitedHealthCare insurance on a PPO plan. I went to an ER in a hospital which UHC lists as in-network. I received two bills (one from the hospital, one from the physician’s group), and UHC explains that it’s because they covered the physician at the in-network rate even though they are out-of-network, and that this is not a balance bill and that I am on the hook for the difference. The physicians group said I can write them a letter requesting they reduce the bill, but that they don’t participate in UHC’s network. This physicians group seems to have exclusive privileges to work in that ER. I’ve read these:https://www.commonwealthfund.org/blog/2019/state-efforts-protect-consumers-balance-billinghttps://www.marylandattorneygeneral.gov/Pages/CPD/Tips-Publications/tip41.aspxhttps://insurance.maryland.gov/Consumer/Documents/publications/AssignmentofBenefitsFAQ.pdf Am I really on the hook for this? It seems like a prohibited balance bill to me, and I haven’t heard any rationale as to why it’s not. How do I prevent this from happening in the future? Thanks!
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