Good faith estimates with commercial insurance?

Have commercial insurance with Cigna through employment. The year started off with some provider visits charging us up front the correct amount (i.e. matched the amount after claim processed), most just did not charge until after the claim was processed.

In February hit the deductible, providers charged the correct 20% amount, most just did not charge until post claim processing.

In March hit the OOP, providers did not charge anything… until one in June. Had seen the provider the previous year, big provider in the state, 100% clear it was in network. They demanded a payment of a few hundred dollars to see the doctor or we'd have to pay a cancellation fee. Told them we had met out of pocket and they said they didn't care. Had all the correct insurance details, but would not run it. A month later, claim obviously says we owe nothing, their charge to us was roughly 74% of what the plan paid. Which makes it seem like they just picked a random number. So now chasing them for a refund, last time had to deal with a billing issue with this provider it took several months to resolve even with EOBs in hand.

My question is that do Insurers or a law, usually require in network providers to give a good faith estimate for upfront charges with commercial insurance? If all our providers charged $$$ regardless then it'd be difficult to afford to keep appointments…

submitted by /u/Tonebr
[comments]

See also  Suggestions on cost-effective Federal Employee Health Benefits (FEHB) plan for single male?