Florida Balance Billing Anesthesia for Colonoscopy

I am under 45 but underwent a colonoscopy in my 30’s that was covered as a high risk screening due to family history during which thankfully nothing was found.

My benefit calculator on my UHC account predicted a $0 cost to me. I later received a bill for $500 from the out of network anesthesiologist. I called my insurance and was told as I thought: this was wrong due to Florida’s balance billing law and the No Surprise Act, that any out of network used within in-network facilities for preventative screening must be covered and charges and balance bills for anesthesiology by OON providers at my in network hospital aren’t permitted. I was told to expect copies of letters sent to the anesthesiologist and a new bill for $0.

I did not. I got another bill for $500, called insurance and was told that my grievance was denied and I was billed correctly as they filed the claim as in-network and it was $1,300 and after plan discount and cost sharing my portion is $500. I am baffled how this is allowed. I had no other choice for anesthesiologist. Why would that not be covered at 100% like everything else?

submitted by /u/buttbutt50
[comments]