What does this mean on the claims summary? Was it denied or paid?
I had to go to the ER a momth ago and was getting muscle spasms every few secondsas a result i couldnt get out of bed nor move. I had to call am ambulance to help me get up and to take me to nearest hospital 1-2 mi away.
When the ambulance arrived at the er the head nurse or someone asked me health questions, then directed me to a bed. They then asked for my insurance card, then gave me meds, then had me pay my copay of $250 and then signed paperwork and gave me a receipt for the copay. I was released after 90 mins with a prescription.
It's been a month later and the claims submitted by the facility (1 for the ER AND 1 for the ER doctor.)
Both claims say they have been finalized. But I can't tell on the claims summary if the insurance paid the provider or not because it says both er and doc are put of network (I didn't know and didn't think about it as I was in alot of pain)
One claim says something like this:
Amount billed: $1231.45
In network savings: -$1231.45
Paid by Insurance: $0.00
Patient Responsibility: $0.00
I assumed at first they were paid cause it says my responsibility is zero but I thought HMOs don't pay out of network claims or was it because of it being an ER?
can someone explain this to me?
submitted by /u/Pure-Pair4157
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