My insurance pays the er docs the full amount if I went to an in network er

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Feb 24, 2021
8:56:00pm

LaserCoug All-American

They’ve done it half a dozen times over the years. I have to call and explain the situation but they always pay out.

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LaserCoug

Previous username: (Private)
Bio page: LaserCoug
Joined: Dec 5, 2006
Last login: May 16, 2024
Total posts: 27,718 (9,914 FO)

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Messages

Author

Time

Health insurance billing question: ER doc trying to charge me more after the negotiated payment

jdub FORMER USER

2/24/21 7:02pm

Have you tried to work with the ERs billing department? If they refuse to work

BYU28_Miami21

2/24/21 7:10pm

I think we called them way back when this all started. We thought it was taken care of then.

jdub

2/24/21 7:11pm

Yes, do. Tell them what happened, show them the documentation. Even without that

TailgateU

2/24/21 10:32pm

Is he/she an out of Cigna network doc?

AT Cougar

2/24/21 7:10pm

Possibly. The hospital was not (Utah Valley), and we got whatever doc was in the ER that night.

jdub

2/24/21 7:12pm

Most hospitals will write off the added expense for those ER visits. However,

jreid191

2/24/21 7:16pm

jreid191

2/24/21 7:21pm

similar experience, we had a billing issue with Utah Valley

ral1988

2/25/21 3:39am

It’s not eliminating surprise payments that’s the issue tho. The bill is the bill. What we should eliminate is surprise

Virginia Ute

2/24/21 7:21pm

But what does the term "negotiated price" mean in that case? It would imply the doctor agreed to it.

jdub

2/24/21 7:26pm

The ER group has a meeting every 5 years or so with the insurer. They negotiate what the insurer will pay for each

Virginia Ute

2/24/21 7:32pm

Thanks man, that's what I'll do.

jdub

2/24/21 7:51pm

Good luck to ya. Hope it gets sorted out.

Virginia Ute

2/24/21 7:57pm

I’ve been in your boat before as a patient tho, and it’s just flat out stupid.

Virginia Ute

2/24/21 7:33pm

Medical billing is awful. That said, I guarantee you that ER doc has no idea that you continue to be billed or that you

Slim

2/24/21 7:17pm

Seriously. The billing sucks so bad. Funny the way he worded it, though. Like the ER doc is just sitting at home sending

Virginia Ute

2/24/21 7:18pm

Yeah, it would have been the ER doc's billing, who then passed it onto collections. I get that.

jdub

2/24/21 7:20pm

I'm sure he doesn't, that's why it's a collections agency. So, what do you recommend? ER billing?

jdub

2/24/21 7:19pm

I don’t really know how to fix it but the ER doc likely works for a large group that is contracted by the hospital. That

Slim

2/24/21 7:23pm

That will be my first call tomorrow. Thanks!

jdub

2/24/21 7:26pm

My condolences for your situation. I HATE that I literally have no idea how much someone is going to be charged for my

Slim

2/24/21 7:29pm

Sane here. As a physician I have been hit with major surprise billing.

BYU28_Miami21

2/24/21 8:20pm

Be prepared:

AT Cougar

2/24/21 8:26pm

cougarfan84

2/24/21 7:40pm

All of this is fixed with the new surprise billing law from dec 2020

BYU '80

2/24/21 8:18pm

This kind of crap makes me so mad. I'm sorry. I hope you can get it sorted out

zerigke

2/24/21 7:50pm

Tell them you consulted your attorney and they need to cease and desist.

Mayor of Cougartown

2/24/21 7:57pm

Tell who? The collections agency? Does that really work?

Slim

2/24/21 7:59pm

yes, the collections agency. Anecdotally I've seen it work.

Mayor of Cougartown

2/24/21 8:05pm

DO NOT DO THIS UNLESS YOU'VE ACTUALLY CONSULTED WITH AN ATTORNEY

Elwood Blues

2/24/21 9:55pm

I have Cigna here in Arizona and they always tell me if I go to the ER for

VenturaCoug

2/24/21 8:01pm

They told us the same thing, and have helped previously. That's part of why I thought this was over.

jdub

2/24/21 8:20pm

I had a similar problem. Eventually I got the insurance company to call the

JustKeyrock

2/24/21 8:21pm

+1. I did this by doing a 3 way call. It also helped that the collection agency

sah22

2/24/21 9:23pm

The beauty of American healthcare.

spugeddy24

2/24/21 8:22pm

If that Doc isn’t in the Cigna network the negotiated rate won’t mean squat to

Fargo

2/24/21 8:38pm

My insurance pays the er docs the full amount if I went to an in network er

LaserCoug

2/24/21 8:56pm

Did the hospital and doc bill separately? If working with the hospital doesn't

ManicBlue

2/24/21 8:57pm

Sounds like there may be a violation of the Fair Debt Collections Practices Act.

jcvlaw

2/24/21 10:19pm

Here are a few thoughts

bigjohn

2/24/21 11:07pm

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