insurance company not recognizing my out of pocket expense
I have just received a bill from my provider for cardiac therapy sessions that I went to back in May (it is now July 1, 2023). My insurance company did pay the majority of the medical bill but according to my provider and insurance company, I still owe a balance, even though I have now met my out of pocket maximum for 2023 which is supposed to be covered 100% according to my insurance policy. The same thing happened to me last year in 2022 after I met my out of pocket maximum deductible. When I called my insurance company they told me that because I hadn't met my out of pocket obligation when the service was performed earlier in the year, even though I had met it by the time I received the bill, I was still liable. It was a minor amount so rather than pursue the matter and argue about it, I just paid it. This time the amount is more substantial. I also want to avoid getting these bills in the future after I have met my out of pocket deductible. I just don't think it's fair, that even though I meet my out of pocket obligation for the year, that because of substantially late billing after a service is performed, that I am still billed like I never met my out of pocket maximum just because I hadn't met the maximum at the time of service?
submitted by /u/StartHonest5151
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