Advice!!!
Over two years ago, my then fiancé had our child and was on her own health insurance. We were at an in network hospital and the anesthesiologist who performed the epidural was a contracted out of network doctor.
The company that the anesthesiologist worked for just billed us for the first time several months ago for the in network cost of $3400 (the original price was around 9k). For some reason my insurance company would only pay $200. I was billed the difference of $3200 by the doctor.
Im extremely annoyed because…
1.) This is something that they have been negotiating for two years and im just now hearing about it.
2.) I have ALWAYS payed my medical bills no matter the absurd cost if the insurance math works out.
Both sides are trying to sympathize with me and act like its the other persons fault and make me the monkey in the middle.
But heres where im sticking to my guns…I know for a fact that we paid the deductible for the year we had our child ($3500). And our out of pocket max was 5k, and we pay 20% after the deductible is met. Even if my insurance accepts the doctors $3400, imonly liable for $680 considering thats 20% of 3400. Is all of this correct?
Ive called my insurace company and theve told me I only owe the doctor $65. The doctor told me they have reopened the case and are renegotiating with the insurance agent. Probably cause I called them a couple of weeks ago and threatened to notify the media and talk to a lawyer.
So my questions really are…
1.) how is it not illegal for my insurance to straight up not pay an in network bill
2.) how is it legal for the doctor to bill the difference.
At the end of the day, this should be a covered cost and I should only have to pay what my insurance tells me I have to pay.
submitted by /u/BigBlueBoyscout123
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