Doctor didn’t know I was receiving bills
This is a more confusing one so bear with me. Please let me know if there is a better sub for me to post this in as I'm trying to get an answer to my confusion.
I got a new primary care doctor this past April because I live in a new area. I was under two insurances at the time so I specifically searched for a doctor that was in-network with both of the plans, and that's how I found this new doctor. I was lucky enough that my plan covers new patient visits in full as long as it's still technically just for an annual wellness visit. I had bloodwork done though which I was of course billed for. I however had to have a follow-up visit with her because she wanted to go over some abnormal test results and do further bloodwork. That was charged as a standard office visit and I was responsible for $30 because of my primary insurance agreement. Unfortunately, I lost coverage from that insurance this past May and I was stuck with the secondary insurance (now my primary). This insurance is high deductible so when I had to do another follow-up with her I was responsible for $185.96. I have also found myself in a very tough financial situation that made it very difficult to pay.
Now, I was seen in the ER last month which allowed me to hit my deductible (I didn't have to pay my ER bills in the end because I had Medicaid from the state I just moved away from which covers emergency visits but not normal out-of-state office visits). After my deductible, I pay 20% of the claim and the plan pays 80%. The ER told me to do a follow-up visit with my primary care to discuss the situation. When I did at the very end of last month I was responsible for $52.44. I know this may sound ridiculous, but with my financial situation getting worse, even that was extremely difficult for me to have to pay. Here's where things get confusing: my doctor called me last week to discuss something that happened in the ER when I brought up not being able to pay her bills. She was genuinely surprised for a moment. It turns out she had no idea I was receiving bills. She even verified that she was in-network with my insurance (my claims also say that she and her office are) and she was very confused. She doesn't understand why I'm receiving bills. I explained the "20%, 80%" thing to her but she said I should not be receiving bills for her office visit if she is in-network.
I did not think this was correct. Does anyone possibly know of a reason she would think that I should not be billed for these visits? Or is she just misunderstanding the plan? I wouldn't think that to be the case though because I talked about the 20% coinsurance with her at a visit before and she said that she was pretty sure that was her insurance's agreement too. Any potential explanation would be greatly appreciated.
submitted by /u/Middle-Bee-6024
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