I enrolled in BCBSTX silver plan HMO last September after I found I was pregnant. I enrolled through marketplace and thought I had a pretty decent plan. From September-December I saw my OB regularly, plus a specialist (twice). During that time I had not met my deductible, but my office visits, ultrasounds were taken care off. Each visit to the specialist cost about $100 per visit. My plan rolled over into 2022, same plan, same doctors, still haven’t met my deductible. Now insurance is covering only $17 for each ultrasound (I’m paying $179 each time). And the same specialist I saw last fall, is now costing my over $1,100 for two visits. Doctors’ office told me it’s because I haven’t met my deductible, but I told them I hadn’t met my deductible last year and I wasn’t charged this much per visit. Talked to BCBSTX rep. Insurance company first tried to tell me it was healthcare.gov that messed up my coverage; talked to a healthcare.gov rep, no changes on their end. Talked to insurance company again, now they’re telling me it’s a coding issue coming from the doctors office. Before I start calling the billing department, is there any words of advice, something I use before going in blindly into this conversation? For instance, I noticed I was charged 3x for radiology services for one appointment (one for ultrasound, one umbilical Doppler, and another for anatomy scan) – is this normal??
submitted by /u/T_OC
[link] [comments]I enrolled in BCBSTX silver plan HMO last September after I found I was pregnant. I enrolled through marketplace and thought I had a pretty decent plan. From September-December I saw my OB regularly, plus a specialist (twice). During that time I had not met my deductible, but my office visits, ultrasounds were taken care off. Each visit to the specialist cost about $100 per visit. My plan rolled over into 2022, same plan, same doctors, still haven’t met my deductible. Now insurance is covering only $17 for each ultrasound (I’m paying $179 each time). And the same specialist I saw last fall, is now costing my over $1,100 for two visits. Doctors’ office told me it’s because I haven’t met my deductible, but I told them I hadn’t met my deductible last year and I wasn’t charged this much per visit. Talked to BCBSTX rep. Insurance company first tried to tell me it was healthcare.gov that messed up my coverage; talked to a healthcare.gov rep, no changes on their end. Talked to insurance company again, now they’re telling me it’s a coding issue coming from the doctors office. Before I start calling the billing department, is there any words of advice, something I use before going in blindly into this conversation? For instance, I noticed I was charged 3x for radiology services for one appointment (one for ultrasound, one umbilical Doppler, and another for anatomy scan) – is this normal?? submitted by /u/T_OC [link] [comments]Read Morer/HealthInsurance