Defeated....::vent::

probe1957

My son had some lab work done the other week.  The lab billed $600.  Blue Cross paid $7.  We are not responsible for the rest.  I guess that is their agreement with BCBS.

This is called a "write-off" and BCBS usually has large ones. It is the offices choice as to whether or not they will "participate" with your insurance. If they do, they accept the write off, if not..you owe the bill. Most people "participate" with BCBS, and there are agreed upon "write-offs" for all services the office offers.

For those of you saying that people wouldn't expect to have electricity without paying the bill, or take your car home from the body shop without paying the bill, these situations are different because you are paying AFTER the service. The way the OP read, this doctor was asking for payment in full before delivery. She was making payments for the services rendered at the time of service.

Although! When I filled out my pre-admission form at the hospital I was going to delivery at I got a letter back saying my estimated bill due at my leaving the hospital would be $xx.xx but that this was subject to change if I had a non-routine delivery. So it's not out of the question for her doctor to change the amount he was charging her but to do it without discussion or explanation is wrong, IMO.

Oh, I wanted to add..b/c someone mentioned how they thought their doctor's office was filing their insurance and they weren't...Doctor's offices are NOT required to file your insurance, that is YOUR responsibility and you should pay close attention to it because you can easily end up on a collection report because you thought someone else was taking care of it. ALWAYS ask your doctor's office if they are going to file your insurance for you, don't expect them to, it is a courtesy not an obligation.

I just want to clear up an apparent misunderstanding of what I said.  I was under the impression that a plan had been agreed upon by the OP and the physician.  I know in GA that there are contracts between doctors and insurance companies.  It is true that there are 100's of plans and each is different.  The doctor or hospital will agree to provide a service for a certain amount of money.  And then according to the patient's policy, the patient is responsible for a certain amount.  This could be a copay or a deductible and a percentage or whatever is agreed upon according to the patient's insurance and the agreement between the doctor.  My doctors always write off the difference, according to the contract.  I know all insurance policies may not be like this, but a lot of them are.  Because I did not know the posters insurance, I stated that she should contact the insurance company.  Yes, I agree it is your responsibility to know what you are to pay and what the insurance company will pay.  The bill is ultimately yours, as it should be; that is why you should know what your insurance will pay prior to getting treatment.  Again, I told her to contact her insurance.  I am also aware that some doctors do not have contracts with insurance companies and you are responsible for the entire amount or the amount the insurance company does not pay, although this did not seem to be the case in her situation.  Another reason I told her to contact the insurance company.

The information about filing with the insurance company--I mentioned it, because I know that doctors don't always do that.  It is a courtesy.  I only brought it up, because I experienced doctors not filing.  I had been in a bad accident, went to the ER and was cared for by so many doctors I didn't even know who they all were.  When I started getting bills, I called the insurance company to check if they had filed.  I was told no and I called and requested that the physician's file or give me information to file.  I also told the OP to call the insurance company to verify that the sonogram had been filed. 

I was only trying to help the OP and to get her to communicate with her insurance company since there seemed to be a problem she hadn't expected.  I told her both of my posts to contact her insurance company, because they are the only ones that can let her know what her policy will cover and won't cover.  I even told her to call them and talk to them until she had an explanation she could understand.