I assume you haven't received the Explanation Of Benefits (EOB) yet. That will break down what the approved costs were and how much was paid.) The first thing the insurance company does is adjust the bill to be a contracted rate. The service providers write off the difference. Then if you've already met your deductible for the year, the insurance will pay their part and tell you what your part of the bill is. I'd guess that the final bills paid will be less than half of the $7,700 when all is done.The cost of the procedure was $7,705. That was for 5 minutes on the table, two x-rays by the technician, and interpretation by the radiologist. No cost after insurance. I wouldn't think that I can get all that done again for zero out of network, and due to the interpretation, it wouldn't be in the insurer's best interest to allow a second opinion.
It is ok to ask the insurance company what your bill will be beforehand. But it is best to provide who/where you would like to go upfront since different providers may have different contracts or possibly are not in-network for your insurer. (Don't rely on what their website lists for doctors who are in the insurance network. Those sites are always out-of-date as even doctors move and get hired by different medical groups every day, just like we can change jobs or retire.
Statistics: Posted by celia — Sun Sep 08, 2024 1:44 am — Replies 12 — Views 681