In New York, I went to an out-of- network provider but they billed my insurance directly and accepted assignment. The provider billed $500 per session. The EOB says the plan discount = $350, max allowed by plan = $150, plan paid = $110, my responsibility = $40. The provider told me that they aren’t limited by the max allowed and they charged me $80 out of pocket because they need to make $190 per visit if they bill my insurance. If I pay out of pocket then they’ll charge me $170 per visit and I’ll save $20 per visit.
- Is my provider allowed to charge me more than what my EOB says I owe?
- Is my provider allowed to bill different amounts to me ($170) vs. my insurance ($500)?
submitted by /u/jellidonut
[link] [comments]
In New York, I went to an out-of- network provider but they billed my insurance directly and accepted assignment. The provider billed $500 per session. The EOB says the plan discount = $350, max allowed by plan = $150, plan paid = $110, my responsibility = $40. The provider told me that they aren’t limited by the max allowed and they charged me $80 out of pocket because they need to make $190 per visit if they bill my insurance. If I pay out of pocket then they’ll charge me $170 per visit and I’ll save $20 per visit.
Is my provider allowed to charge me more than what my EOB says I owe? Is my provider allowed to bill different amounts to me ($170) vs. my insurance ($500)?
submitted by /u/jellidonut [link] [comments]Read Morer/HealthInsurance