why does it apply to ONN accumulator?? Can S.O explain for me
Could someone explain me better about No Suprise Act I had a sugery on March 9th in an in-network hospital. However, my specimens were sent to an OON facility and examined by OON provider. I recently received a bill from pathology dept, they are trying to charge me full price of what they claimed the insurance ($752).
EOB show: -Provider billed: $752.00 Plan benefits: -Plan discount: S498.92 -Plan paid: $0.00 Your cost -Applied to deductible: $253.08 -Copay: $0.00 – Coinsurance: $0.00 Total plan benefits: $498.92 Your total cost: $253.08 Your cost explained You hadn't met your deductible yet. That means you pay for cost of care until you meet your deductible, then we begins sharing the cost of your care. Service description Pathology examination of tissue using a microscope, intermediate complexity
I asked my insurance if it was processed as INN or OON, they told me that it was processed as INN. Then explained to me me “The claim is Out Of Network (OON) and applies to the 00N accumulators. The claim was "bumped" to In Network (INN) as a surprise bill in order to process, however it still applies to the OON accumulators.” It doesn’t make sense to me at all. Isnt I was only supposed to responsible for 20% coi insurance as how my in-network stated. what is the point of changing to INN to be able to processed and applied to ONN? What do I need to do now?
Thank you for any suggestions in advance
My insurance policy for in-network: $0 deductible, $1500 out-of-pocket (which I already maxed out for this year), 20% coiinsurance.
Out of network: $500 deductible, unlimited out of pocket, 50% coinsurance.
submitted by /u/Lazy_Letterhead7879
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