Who is Responsible for a Surprise Medical Bill?

[leroyjenkens]

Hello. I went to the plastic surgeon last year to have a procedure done. He told me what he would do and I waited a few months for my insurance company to respond to the surgeon office's inquiry to find out how much I would be paying and how much the insurance company would be paying. I found out I would pay $200, and the insurance company would pay the rest.
I had the procedure done and paid the $200.

Months later I receive a bill in the mail for $600 from that procedure. If that is money that the insurance company didn't pay, am I responsible for it? If the insurance company agreed to pay all but $200, but then reneged on the deal, then that has nothing to do with me, right? Because I'm going to tell the doctor's office that they need to talk to the insurance company and try to get the money from them, because I'm not paying it. We had a three way agreement for how much I would pay. If I knew it would cost me $800, I wouldn't have had the procedure in the first place.

The way I figure it, they're just coming after me for the money, because they think it will be easier to get the money from me instead of the insurance company.

Or are agreements like this tentative? If I have a procedure that costs a million dollars, and the insurance company agrees to pay 99% of it, but then later decides to pay 0% of it, am I just ruined for the rest of my life by being in debt a million dollars? That makes absolutely no sense to me.
Thanks.

 

[phyzguy]

Welcome to medical care in America (I assume you're in the US). I've seen this happen before. I think medical offices send out bills like this and hope you pay. If you pay, great. If not, all they're out is a few letters. Tell them you paid your share and they need to talk to your insurance company if they aren't happy.

I once had a medical office send me a bill for a procedure I had already paid for. When I refused to pay, they sent it to a collection agency who started sending me threatening letters. I sent the medical office a letter with a copy of the canceled check and told them if they didn't stop harassing me I would hire a lawyer. They shut up.

 

[Evo]

leroy, we don't know anything about your medical insurance. You need to call them. Thread closed.