June 2008 Weddings
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WWYD re Insurance?

With my health insurance, my entire pregnancy and delivery was supposed to cost $150 (for the copay to the hospital) so long as I went to an in-network physician and facility.

I had a c-section and the hospital/my doctor used a surgical assistant that was out of network.

My insurance sent me a letter explaining that they would only pay the in network amount and the rest was my responsibility and included a check for $339.  It said that I'm supposed to pay the difference of ~$600-700 myself.

My flex spending account is automated and direct deposits the amount that the insurance says is my responsibility anytime I use my insruance.  So ~$600-700 was deducted from my flex account and deposited in my checking account.

So now I have a check for $339 and cash of $600-700 for a doctor's bill that I have never received.  The only info I have on the surgical assistant is his name from my insurance explanation of benefits.

I'm not sure who to call.  The insurance?  Track down the surgical assistant?  The hospital?  I don't want to spend the money and get a bill later.  Or really pay at all since I did what I was supposed to and went to in-network providers.  Anyone dealt with this sort of thing or have suggestions?

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Re: WWYD re Insurance?

  • You will probably get a bill. If you are just now hearing from your nsurance com the doc probably just got the adjusted payment and will bill you the difference.
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  • imageamybyrd:
    You will probably get a bill. If you are just now hearing from your nsurance com the doc probably just got the adjusted payment and will bill you the difference.

    I got the check from my insurance company 3 or 4 weeks ago.  I just now noticed the deposit in my checking account though.  I guess I will give it until the end of the year.

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  • The assistant may have written off the balance since obviously your doctor and your hospital were in network. If you have the assistant's name, I would call the hospital and try to find out where the bill would be for that person and then call to ask if you have a bill and if so when you will receive it. You shouldn't have to track them down, but it is better than finding out in a few months you have the bill.
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  • I agree with Lisa.  I also think you can fight the insurance if they bill you because, like you said, you did the right thing.
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