If surgeon in-network has insurance claim denied, can you pay the balance at the discounted rate?

If a provider is in network but the claim is denied, could you simply play the discounted rate that was negotiated between the insurance and provider?

Or would you need to pay the non discounted rate?

Basically I have blue cross blue shield of Puerto Rico Gold PPO. It’s a BlueCard plan but it’s at their discretion if they will reimburse in the USA depending on if the equivalent service is in Puerto Rico.

A provider is contractually obligated to accept if they are a BlueCard provider but it’s highly likely bcbs Puerto Rico would deny the claim.

Could I then pay the discounted rate myself?

It’s wild because this jaw surgeon is 50k out of network but in network would be 4K or so for the cpt codes he bills and the insurance pays out. (Bcbs)

Since I was in network and if the claim is denied i don’t see why I couldn’t pay the discounted rate. Technically there is no negotiated contract between me and the doctor, but the price difference is wild

submitted by /u/I_ask_questions_thx
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