Deductible and OOP met, insurance didn’t cover full cost.

Hello, all! I (editing to add: 33 years old, Michigan, and EGI $43000) plan to call insurance Monday, but figured I would post here in case anyone knew offhand.

I met both my out of pocket and deductible, which were $4,500 and $3,200. I recently had a surgery, and typically since meeting the max, every EOB says that the "Amount You Pay" is $0.00, but this time that isn't the case. The EOB (which I do know is NOT a bill) has explained:

Total charges: $43,123.61 minus Discount: $11,835.41 minus Blue Cross Paid: $19,302.20 Amount You Pay: $11,986

It also notes beneath it that both the OOP and deductible are met.

My question is: why are they listing an amount I pay when I have paid everything and typically that amount is listed as zero? Also, if the amounts are listed as above and I don't have to pay that, what happens to the additional cost-is that something the insurance and doctor negotiate?

submitted by /u/imnocatlady
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