by smogen1 » Mon Nov 29, 2010 03:45 pm
Wife is covered under both her group insurance and my group insurance.
For the sake of ease, numbers are rounded.
Had $10k surgery. Surgeon's office billed $10k to each insurance.
Her group insurance paid first, but their contract called for a $5k discount. Then we owed $1k deductible and coinsurance after her insurance paid.
My group insurance (high deductible) paid next - only $1k discount and called for $3k deductible/coinsurance, so it paid the surgeon $6k.
Surgeon's office is saying they put $1k of my group plan's payment toward covering her group plan's deductible, but that they get to keep the other $5k to cover the contracted discount her insurance had.
What is right here? This is in South Dakota.
Thanks
For the sake of ease, numbers are rounded.
Had $10k surgery. Surgeon's office billed $10k to each insurance.
Her group insurance paid first, but their contract called for a $5k discount. Then we owed $1k deductible and coinsurance after her insurance paid.
My group insurance (high deductible) paid next - only $1k discount and called for $3k deductible/coinsurance, so it paid the surgeon $6k.
Surgeon's office is saying they put $1k of my group plan's payment toward covering her group plan's deductible, but that they get to keep the other $5k to cover the contracted discount her insurance had.
What is right here? This is in South Dakota.
Thanks
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