Hi all, I have a corporate-sponsored high-deductible plan with Aetna. Out of pocket max is $5,000. Providers often charge us before/after but while still in person for the visit. First off, these charges don’t make it to Aetna accurately; Aetna might say we paid $7, but in fact we were charged $75 by the provider. Therefore, Aetna doesn’t really know what I have been paying out of pocket, which is a problem.
Regardless, when close to the out of pocket max timing, I may have already hit it but Aetna isn’t showing that to be the case – so the provider charges me for example $75. Then once Aetna catches up, it’s clear that I didn’t need to pay.
Am I supposed to file some claim with Aetna to get reimbursed for the $75? Or am I supposed to contact the provider and get a refund?
Just strikes me that I end up paying closer to $5,300 or so out of pocket because of delayed billing.
submitted by /u/maceinjar
[link] [comments]Hi all, I have a corporate-sponsored high-deductible plan with Aetna. Out of pocket max is $5,000. Providers often charge us before/after but while still in person for the visit. First off, these charges don’t make it to Aetna accurately; Aetna might say we paid $7, but in fact we were charged $75 by the provider. Therefore, Aetna doesn’t really know what I have been paying out of pocket, which is a problem. Regardless, when close to the out of pocket max timing, I may have already hit it but Aetna isn’t showing that to be the case – so the provider charges me for example $75. Then once Aetna catches up, it’s clear that I didn’t need to pay. Am I supposed to file some claim with Aetna to get reimbursed for the $75? Or am I supposed to contact the provider and get a refund? Just strikes me that I end up paying closer to $5,300 or so out of pocket because of delayed billing. submitted by /u/maceinjar [link] [comments]Read Morer/HealthInsurance