I am so confused about what part of my bill is going towards my deductible.
Okay so a little back story. I am pregnant. My OB office has a payment agreement in which I prepay for all the regular services related to my pre-natal care and they run a benefits summary and estimated costs. I just had my first appointment and they gave me this summary and said I didn’t have to pay it until my next visit. I am going to type a synopsis of the summary since I can’t attach a photo or post a link.
“My insurance benefits: Anthem policy renewal date: 1/1/2023. Annual deductible: $6100. Coinsurance N/A. Out of pocket max: $6400
My estimated costs for OB services: Deductible allowable $2655 + Coinsurance N/A = $2655 (appears on initial statement)
Ultrasounds $547: 1. Transvaginal (confirmation of pregnancy) 2. Nuchal transluceny (13wk) 3. Transvaginal + abdominal 20 week anatomy scan (estimate for 3 routine U/S to be billed as they occur)
Total due: $3202
Payment plan options: Pay in full Pay spread over 6 months Pay half now and pay the rest over 5 months”
Here is where I’m confused. I got the first claim on my insurance for ultrasound 1. However I had both ultrasound 1 and 2 in the same appointment because I was further along than I thought. It appears I was only billed for ultrasound 1. $150. insurance accepted $133 and applied that to my deductible.
The $2655 can be paid online on my OB website but does not appear to have been submitted to insurance. The prenatal visit was submitted to insurance and showed as “charged $0”.
If it says “deductible allowable $2655” shouldn’t all of that be submitted to my insurance company and count towards my deductible?
I’m confused how this payment plan is working. If I have to pay this all up front, would the OB office have to refund me for what the insurance company doesn’t allow them to charge (for example they filed a claim for $150 ultrasound that I assume I’m paying all of in this payment plan even though insurance only approved $133 to be billed to me).
Any ideas? I’m mainly curious if this $2655 will be applied to my deductible once paid and how this works if I pay it prior to a claim being submitted. Any ideas?
