What happens if claim is rejected (w out appealing)
TLDR: If the health insurance company denies a claim who must the customer pay the medical bill too? Do they pay it to the health service provider or do they pay it to the health insurance company?
Context: Essentially i am still active on my former employer’s health insurance. I left the 7 months ago. I went for a doctor visit for a checkup. The receptionist told me the price and i payed right there in office. They didnt even ask me for my insurance info. i just assumed i was paying out of pocket. When i went home i looked at my receipt i saw what the bill was broken down into. It said that my former employer health insurance picked up part of the bill
I understand the insurance portion of the bill will be sent by the doctors office as a claim to the insurance provider, waiting for approval or denial. I have a strong feeling the claim will be denied since i no longer work for that company.
All the information i could research online are about the appeal process. I am not interested in appealing. I will just bite the bullet and pay out of pocket for the office visit.
I am just curious who i need to make the check out to. My dr office or the health insurance company?
submitted by /u/Wooden_Percentage551
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