Out of Network Claim
Hi there, 30F, NY ~$100k
Just had a bit of a panic, but now think it’s an error on either the doctor or insurer’s end.
I went to an in-network provider for a medical procedure that required sampling some cervical tissue. All went smoothly and I didn’t hear anything from the doctors office.
Now, a couple weeks later I see a few things in my claims. The first is the processed claim for the visit, that comes with a $25 fee. Expected, no problem.
Next I see a $3,150 claim with 3 separate claim codes with an in-network lab. All processed and paid, $0 owed by me.
But THEN I see a $3,100 claim from an out of network lab with the identical same 3 claim codes and it says I owe that full amount. The claim says it has been processed fully.
No one ever contacted me about using an out of network provider, and it seems the exact same procedure was handled and paid for with an in-network lab.
I haven’t received any mail or notification of a bill yet, but the claim says processed. I plan on calling tomorrow, but just wanted insight about how likely it is that I’m on the hook for this?
