Provider trying to bill me 5% copay after we hit Max Out of Pocket and Insurance paid 100% of bill

My wife went to an in network optometrist who insisted we pay upfront and advised we will get reimbursed after the insurance processed the claim. Apparently we were the first people to come to them with United Healthcare Select Plus. It was a couple days after Christmas and they were the only ones with an appointment available so we went twice before the end of the year. It took my insurance about 3 months to process the claim and I allowed a few weeks for the provider to refund the payments we made. I sent the provider a copy of the Explanation of Benefits which showed the allowable amount which was paid 100% by the insurance and $0 copay for me. We hit our maximum out of pocket last year so the 5% copay doesn't apply but they read on the back of the insurance card that my copay is 5% and they insisted that I pay 5% of the amount billed and NOT the allowable amount! Crazy…am I right? I probably shouldn't have paid up front but we were just happy enough to get an appointment when we did.

submitted by /u/j0shuascott
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