Let's see, anyone ever have issue with insurance companies? Oh, I'm sure you have. They try to bulldoze people! Here's the deal. We used a local, in network provider last year. The provider billed the insurance for XX amount. According to our plan, we are responsible for the deductible plus 20%. Sounds easy and straight forward. But, here's the twist...
The insurance company uses a third party to manage the claims. This third party added an administrative fee OVER AND BEYOND the patient liability covered by the insurance. This means that when the insurance company cut the check to the third party, this third party then took their administrative fee out and sent the provider less money. As a result, the provider is billing us to recover the administrative fee.
We have appealed to the insurance board! In our appeal we stated that any further action for the provider to recover the amount that the third party stripped from their payment is between them and should be reconciled as such. The patient liability amount has been paid in full. We expect full support in reconciling this administration fee without any further billing from the provider.
What do you think? Is it worth the aggravation?