Do I Deserve a Reimbursement?
I have been going back and forth with a previous provider’s office since March on this issue. I really need help understanding the issue so the office manager will not be able to bully me into submission again.
Im a Texas resident with BCBS PPO low deductible plan.
So back in February I was referred to a specialist after a concerning test. I got into them fairly quickly however they required payment before services. I went in believing that I would only have to pay my specialist co pay but was charged much more. Hundreds more. I obliged because I wanted to make sure I wasn’t dying. They explained the cost to me that since my deductible hasn’t been met that I need to pay in full. Anyways fast forward a week I get my EOB,
Billed Amount: $1,308
Discounts and Reductions: $852.26
Amount Covered (Allowed): $455.74
Health Plan Responsibility: $395.74
Deductible Amount: $0
Copay Amount: $60
Amount Not Covered: $0
Your Total Costs: $60
I paid them $329.08
I don’t understand how my insurance is saying that I only owe them the co pay while they’re saying that is not true since I haven’t met my deductible. Nothing I paid went towards my deductible. All the insurance agents I’ve spoken to say I’m owed a reimbursement but the office keeps repeating that they billed me correctly.
I have another 3 way call with them and insurance next week and I’m a nervous wreck. The last insurance agent backed down and essentially gave up on speaking to them. I need this money and there is also another bill it appears I was over charged by them for. All of the agents I’ve spoken to prior say I’m owed a refund yet the office keeps repeating the deductible situation.
Please help me understand the situation. I feel like there’s only 2 answers, I was over charged or insurance messed up and didn’t apply payment to my deductible for some reason. I’m feeling really defeated.