Having trouble with billing from an old ultrasound appointment

Hi all,

Thanks in advance for any help you might be able to provide!

I was pregnant in 2021 and delivered in early 2022.

Anyways, I’ve gotten all of my bills and everything from my delivery and pregnancy figured out but one that was for $12.

It was from the ultrasound department within my OBGYN office (separate company but is inside the same office) and honestly I’m fairly certain something isn’t right with it but $12 isn’t really worth my time to be calling my insurance and their office back and forth.

I called to pay the $12 as I couldn’t do so online, and that’s when they told me I actually had another separate bill for $645. I had never received this bill in the mail, and I’m very good with keeping up with stuff like this so I know they just likely never sent it.

I asked them to resend the bill, which they did. I finally got the bill in the mail for the $645 and it’s from an ultrasound I had done in November of 2021. The codes on the bill are 76811 (labeled as U/S Fetal and maternal eval single) which was billed at $645 and 76817 (labeled U/S OB, transvaginal) which was billed at $349.

It shows -$219.30 under “payments”, which I’m guessing is what my insurance paid them, and -$104.70 under “adjustments”, which I’m guessing is maybe a discount for a contracted rate they have or something? It also shows -$25.00 under payments as well, which was my copay I paid at time of service. So the total balance after all of those payments/adjustments is now $645.00.

I looked this claim up on my health insurance provider’s website, and it does show the same numbers and amounts. Next to the $645 charge, though, it has a “(1)” and then a little further down it shows this: “(1) You do not have to pay this. Your plan pays for charges we find to be reasonable and appropriate. This charge is considered part of another procedure performed on the same day.” I’m not sure if that’s helpful at all.

I’m confused because I don’t see why my insurance wouldn’t cover either of those things. I plan to give my insurance a call today and ask why exactly it wasn’t covered, but I’m wondering if there’s anything I’m not understanding or anything specific I might need to ask?

Thanks again!