Posted: 12/1/2004 8:06:24 AM EDT
| I had to have a MRI about a month ago at a place that was "out of network", however they told me that they would only charge me what my insurance company would charge me if they were "in newtork". I received a bill last week, before my insurance paid anything for around $2000. My insurance only paid $491 and when I called to see what my balance was after my insurance paid, the person told me that my balance was $0. It was strange how much they came down. I guess that just goes to show you the benifits of medical insurance. |
| Mantis, you noted a common occurance in the medical billing field, which has a few causes. First, the amount of the bill is significantly inflated, well above what they are expecting. This is done b/c we cannot have multiple fees for different plans and different patients, and we can't take a chance that the number we pick will be lower than what some plans will pay, so we pick an arbitrarily high number, knowing that we will not get that amount, but will maximize reimbursement. Secondly, most will write off any balance due, b/c in this day and age there is a lot of shopping around, especially for covered procedures. The facility you went to probably recognized you would go elsewhere if they did'nt work with you and be flexible. I'm not saying that this is right or wrong, but it is a reality of health care today. By the way, the facility is committing fraud if they do not make at least one good faith attempt to collect a balance due, so don't be surprised if somewhere down the road you get a bill, and then never hear from them again. |