An ER visit in May should have met my $1500 in-network deductible, but the hospital did not file my insurance correctly at first, and two months later GEHA is still processing those claims. Same story with follow-up visits to a specialist, who has also charged me enough to meet that deductible, but the provider filed incorrectly at first and then GEHA screwed up when I asked them to correct it. According to GEHA’s website I have almost met my out-of-network deductible (despite only visiting in-network providers), but the in-network bar is pretty much empty as they work on relabeling all these claims as in-network.
In the meantime, I have been paying full office visit charges (I pay 100% until my deductible is met, then I pay 5%) at the specialist, at a radiologist, and at PT – usually $100-$150 every visit. I understand that these copays do not count towards my deductible, but my in-network deductible should already be satisfied and I should have been paying 5% at all of these follow-up visits.
Once the billing issues are resolved and my in-network deductible is officially satisfied, will I be able to get reimbursed for these office visit copays that I should not have paid in the first place? Or do I need to cancel all future PT appointments until GEHA fixes their mistakes?
I have not been able to get a clear answer from GEHA, the HDHP plan brochure, my providers, or the internet. Please help me figure this out, and thank you.
submitted by /u/churlisher
[link] [comments]
An ER visit in May should have met my $1500 in-network deductible, but the hospital did not file my insurance correctly at first, and two months later GEHA is still processing those claims. Same story with follow-up visits to a specialist, who has also charged me enough to meet that deductible, but the provider filed incorrectly at first and then GEHA screwed up when I asked them to correct it. According to GEHA’s website I have almost met my out-of-network deductible (despite only visiting in-network providers), but the in-network bar is pretty much empty as they work on relabeling all these claims as in-network. In the meantime, I have been paying full office visit charges (I pay 100% until my deductible is met, then I pay 5%) at the specialist, at a radiologist, and at PT – usually $100-$150 every visit. I understand that these copays do not count towards my deductible, but my in-network deductible should already be satisfied and I should have been paying 5% at all of these follow-up visits. Once the billing issues are resolved and my in-network deductible is officially satisfied, will I be able to get reimbursed for these office visit copays that I should not have paid in the first place? Or do I need to cancel all future PT appointments until GEHA fixes their mistakes? I have not been able to get a clear answer from GEHA, the HDHP plan brochure, my providers, or the internet. Please help me figure this out, and thank you.
submitted by /u/churlisher [link] [comments]Read Morer/HealthInsurance