r/personalfinance • u/trebory6 • Sep 02 '22
Psychiatrist did not verify my insurance before our appointment. They say they don't take my insurance, my insurance says they do. Now the psychiatrist is asking me to pay out of pocket Insurance
So Psychiatrist did not verify my insurance before our appointment. They say they don't take my insurance, my insurance says they do. Now the psychiatrist is asking me to pay out of pocket while my insurance is saying they can't do anything because they can't force the provider to use insurance. What can I do?
Edit: I just got off the phone on a 3 way call between my insurance and provider assistant, and my insurance basically no bullshitted the assistant by asking for the tax number and another number and then confirmed 100% that they are in network and provided all the information, and that she'd have to put in a report if they still say they can't accept my insurance.
Assistant ended up saying they called my provider and they'll use some "old system" to bill me, and the 3rd party verifier they use was adamant they weren't in network for me.
They ended up complying and allowing me to pay my $50 copay. So either it was an obstinate assistant or just typical insurance bullshit. lol
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u/cantgetoutnow Sep 03 '22
Technically, it they are contracted with your insurance they must bill your insurance. If you pay cash demand they produce a super bill. You can send your superbill to your insurance and if they cover the treatment you will get the exact dollar you paid back. If not, if you get less, the Dr. Is again in breach of their contract with that ins co. The can only charge you the “allowable”, which is what you’ll get minus any deductible you owe or copay or co-insurance. Good luck!