Anyone have experience submitting concierge GP payments to ins as an out of pocket expense?

I pay quarterly to belong to a concierge GP and a 24/7 urgent care. (Manhattan, regular drs offices are impersonal, horrible and Kafkaesque.)

I’m prepared to eat the cost if I must. But finding out whether it’s considered an out of pocket (OOP) medical expense from United Healthcare (UHC) is, of course, Kafkaesque.

I called UHC 2x to l ask if these costs are counted as out of network. So, it’s a yes or no question, right?

On both phone calls the reps talked a lot but never gave me an answer. They’re like you can try to submit it to find out.

I can’t submit it because when you submit out of network stuff you need per line item, the procedure code and a $ cost for said procedure code. I can’t submit the online form. Billing is separate from the services.

I’ve reached out to the HR benefits person at my office who said they will ask their contact at UHC, no word yet after several days.

It’s mind blowing that a) i have to pay thousands a year just to have a GP office that answers phone calls and emails in a reasonable time, b) UHC reps are unable to tell me whether it’s included or excluded from my policy. (Isn’t that what customer service reps do as a job?!) and c) I can’t submit it on the online form because of formatting.

🤯

Just wondering if anyone else has experience w concierge drs expenses whilst on a health ins plan. Maybe it’s generally not considered an out of pocket medical expense, maybe it is. I have no idea.

Thx. 🙁

submitted by /u/bettyx1138
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