Source
r/Insurance•
MJGSimple

[NY] Is this balance billing? Do I ask my insurance or bring this up to the biller?

Health Insurance

Hopefully a simply question for you all:

Had a set of diagnostic scans done. In Network, requested by doctor. EOB says everything was covered and $0 due. Receiving bill (admittedly not much), from provider. Confirmed it's for the same event.

What's my next step? Have another visit this week which can't register for without paying, so just trying to get this resolved ASAP.

Posted Jun 6, 2022, 2:27 PM UTC

23
starriss•

If you’re sure they’re in network, contact the provider and ask them why they’re balance billing you. If they have a contract with your insurance, they have to accept the contracted rate.

1
MJGSimpleOP•

Thanks!

I am sure they are in-network. The EOB specifically says they are in-network so the in-network rates were used. Everything lines up as I would have expected.

I will have a conversation. The bill was an electronic thing so it doesn't break things down. I guess asking for an itemized bill might also help.

1
dial2deliver•

you’re likely being billed for charges not covered by co-pay and if you haven’t hit your deductible you pay it all until you hit deductible. tell your provider you weren’t made aware of any excess charges and you’re certain your co-pay will cover it and if not to discuss with your health insurance provider, let them both argue over billing codes for a few months.

1