I’ve been seeing my primary care doctor for about 5 years. Through those 5 years I’ve changed health insurances 3xs. Each time she was always in network. Slowly her rates increased from $65-$85. Which is fine. Recently I got a new job so new insurance. I was looking through my insurance profile and noticed my doctor billed the insurance for 2 things.

Said consultation up to 25mins

Wellness check It very much was just a wellness check. Now here is where the scamming question came to mind. My insurance was billed for the 25mins and said I was responsible for $46. They paid about $125. The wellness said zero as this is always free once a year.

The thing is, every single time I go I pay her fee of $65-$85. But then she has been billing my insurance which I back tracked and my insurance is saying I owe less than what I was charged at the office. When I called my insurance they said my dr is not allowed to bill me more than the amount on the statement. At this point I’m super confused because I have to pay before she sees me.

So am I wrong in seeing this as a form of double dipping. She charges me her full rate currently $85 but per my insurance she didn’t report that to them. So it’s not counting toward my deductible. But Then she charges my insurance upwards of $200 which they pay a portion of.

I hope I’m misunderstanding something because this has been the same routine for years.

See also  COB non-duplication