I recently wrote about how I need $1725 for medical bills and how crazy it was making me. I finally got confirmation from the hospital on why I needed to get this money to them.
Apparently this is the money that I still have left for my out of pocket expenses before the insurance kicks in. I guess you can tell that I just started working and have no idea what is going on with my insurance right?
So this amount is the out of pocket that must be paid before they start billing the insurance company. Now when I had to spend some time in the hospital last year I only had to pay the copay amounts but this had something to do with the fact that the hospital was where the doctor worked and it was in network…or something.
This time the hospital is a specialist hospital and it was a referral from my regular doctor and the surgery is expensive so I have to meet the rest of the out of pocket expenses first.
Now it makes sense to me….but I still don’t have that money and the hospital policy is very strict when it comes to payment.
That sounds like a very fishy policy of the hospital in regards to having you pay before they will bill the insurance. I did medical billing for 3 & 1/2 years (physician and surgical centers).
The normal procedure for medical billing is: Provider sends bill to insurance, insurance reduces provider’s bill to the allowable for the work done, insurance pays portion of allowable based on your policy, provider sends you a bill for the remainder of the allowable owed.
That is what happened the last time I went to the hospital, all I had to pay was the copay.
I have no idea why it is different here. I have asked and they say that is the way it is. If I end up overpaying then they will issue a refund..but that takes about three months to clear. 🙁