Medical Bill Negotiation

Hello,

New to this sub. If there is a better place to ask this question, please let me know. I apologize in advance for the long post.

I am having some issues with Corewell Health in Michigan and my insurance. I had an outpatient surgery in February, which is the second time I’ve had this surgery. The last time was in 2020.

I have two health insurance plans. One is a basic plan through CareFirsr BCBS, the other is an indemnity plan through Symetra. My claim for the outpatient surgery was denied by CareFirst because my plan does not include benefits for outpatient surgery. The claim was sent over to Symetra, and they paid 3% of the bill. Neither insurance company negotiated a contracted rate with Corewell health. When I questioned both companies about this claim, they said that I could negotiate with the provider myself.

I have tried to speak to several people at Corewell health to negotiate the bill, and I have been told that they do not negotiate bills. They said they bill based on what my insurance says is my responsibility.

I bring up the first surgery because I had different insurance at the time. The itemized bills for both procedures are exactly the same. The first time, the provider accepted a 47% contractual adjustment from my insurance. I have asked Corewell if they could accept a similar adjustment this time around, and they said they cannot offer that. I have spoken to patient relations, billing customer service, and financial assistance. I do not qualify for any financial assistance because of my income, and I don’t qualify for an uninsured rate since I technically have insurance.

I have a few questions coming from this. If you could answer any or all of them, I would greatly appreciate it.

Is Corewell really not able to negotiate the bill for some reason, or are they simply refusing?

If negotiation is possible, am I talking to the correct people, or is there another department / someone else I should be talking to?

My employer offered two plans. The basic plan with a monthly premium of $300, which I have, or a high deductible plan with a $540 monthly premium. Would the high deductible plan have been better? I don’t go to the doctor often, and this was the only major claim I’ve had since starting with this insurance.

3a. Would I qualify for healthcare through the marketplace?

submitted by /u/MundaneEggplant7187
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