Medical Claims Payments questions

I have AETNA PPO, standard policy with copays. The coverage is excellent. My annual OOP is $10k maximum for family. Deductibles for family is $12,000. Deductibles are met. I go to an “in network” neurologist. Paid the copay. Pre authorization is necessary for an expensive treatment. Obtained and in force.

Here’s my question. I got service for migraines and doctor billed Aetna $6,000 for anesthesia service. Aetna contracted rate back to them was $2,100. Doctor was reimbursed $2,100 by Aetna. Six months later, I get a bill from the neurologist for $2,600. In fact they send me a link that shows a running ledger of what I paid, what Aetna pays and the balance. The policy provides an out of pocket maximum per year. Can someone explain to me, do I owe the doctor the difference? As I said, deductibles have been met. Out of pocket maximum has been reached. How does that work? This is the only doctor I’ve had this experience. I’ve had all kinds of wacky billing issues when I was originally hospitalized for the accident. I had thousands of dollars of billing errors corrected. About things like, they were out of network. You weren’t pre authorized. You have to meet your deductible. You have a policy limit. Etc. So I keep every bill, every EOB, every pre authorization, all coverage limits. And I don’t pay anything without review.