Wife had a back procedure done and insurance told us after the fact that the surgery center was not in network.
I’ll try to provide enough details- I’m getting them from my wife who is herself confused about this. My wife’s doctor recommended that she have a 2 part procedure done to relieve her back pain. Our insurance approved the procedure, and when my wife showed up for it they told us our portion of the bill was $500. We wrote them a check and she had the surgery. Now weeks later we have received a long itemized bill from the doctor’s office surgery, that says we now owe $1000. When we asked why we owed anything else, the doctors office said that apparently the surgery center is not in network for our insurance, even though it’s the center that my wife’s doctor practices at, and is in fact in the same building as his doctors office. I understand location has nothing to do with insurance coverage but…
My wife has had this procedure before which ended up costing even more due to some billing code confusion, so I’m already pretty wary of being duped. And she still needs the second part of this procedure so I’d like to untangle this mess.
My main question is:
Insurance covers her doctor’s office visits but if that doctor recommends a surgery, and they don’t cover his surgery center, shouldn’t that info have been given to us before the procedure?
Are there any other irregularities here or did we just not ask the right questions before this procedure?
submitted by /u/MuseumGoRound13
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