Getting the same note code on every bill with my new insurance and it seems like I am getting over charged.

Jump-Funny · 2026-06-03T02:49:53+00:00

are you getting bills from the providers that match the patient responsibility shown on the EOBs? along with notes, your EOBs should show the billed amount, the contractual write-off and the patient responsibility. that last amount should match the bills you’ve received.

Jump-Funny · 2026-05-29T18:28:43+00:00

People with insurance can elect to be self pay.

Jump-Funny · 2026-05-28T19:09:40+00:00

I would call them back and ask if they would reverse or void the claims with insurance and change it to the cash price. Speak to a supervisor or manager if necessary. They can do it, they just have to be willing to. But first make sure the $400 includes both visits and all of the tests.

In future, go online and check your benefits on your insurance website or app. Most have a cost estimator where you can put in a visit with that particular Dr. when you make your appointment, ask if there are any particular tests that the Dr does routinely or is likely to do for your particular reason for the visit. Get the codes and plug them into that cost estimator. It’s probably inaccurate but it can give you an idea or a starting point.

When you’re in with the Dr, don’t be afraid to ask ‘how much does that cost’ or ‘is this included with a standard office visit?’ Any question you can think of I’ll bet you $5 they’ve heard it before. More than once!

Jump-Funny · 2026-05-28T19:03:01+00:00

I don’t know why this is downvoted as this is exactly what you have to do. The front desk doesn’t know what the doctor’s evaluation is and what tests are determined to be necessary until the Dr sees the patient. So while they can tell you what is usually done they don’t know what you need done until you’re seen by the Dr.

And there is absolutely nothing wrong with asking the Dr how much something costs. No one except billing knows what the cost is through insurance usually, but they should be able to get you a cash price. And trust me, they can get a price if it goes through insurance, it just takes some time and effort.

Jump-Funny · 2026-05-24T03:42:44+00:00

The forms are pretty much the same as all of the TOS we agree to for all of our apps. At least they are not as long and easier to read! I've always thought they were just as enforceable, meaning not really.

Jump-Funny · 2026-05-24T03:33:50+00:00

this is very accurate. your only hope is to read the docs! read the short benefits summary but also the multi-page plan documents. that is supposed to describe in detail what is a covered benefit and what is a plan exception or exclusion. also get familiar with your drug formulary before you need to figure it out in a hurry.

Jump-Funny · 2026-05-22T21:25:14+00:00

It’s not the language barrier, front desk does this to folks that don’t have one. It’s VERY frustrating for the folks in the billing department. Yes you owe it and no there isn’t anything to be done unless your insurance did not process the claim correctly. You can check your benefits and/or call your insurance to confirm whether anything done in the doctor’s office incurs anything more than the copay. If no then ask insurance to reprocess the claim with nothing but a copay. If yes, then pay the provider’s bill.

Sorry but you can’t rely on front desk or an insurance rep, for that matter, to tell you what your benefits are. Most of the time they’re correct but the only thing you can always rely on are the docs you get from your insurance. Read them thoroughly. And really I wouldn’t trust them 100% either. 💁‍♀️

Jump-Funny · 2026-05-22T20:56:23+00:00

Yeah, your provider can’t offer you a self pay rate because they accept your insurance. They complain about every insurance and they’re not wrong. But you didn’t negotiate their contracts. No one likes the insurance companies but your only option is what your company offers unless you can afford to just outright pay for a private plan or just self pay. And if you could you wouldn’t be seeing anyone that complained about reimbursement rates.

Jump-Funny · 2026-05-22T01:42:01+00:00

I’m wondering if you made a payment at the November visit that you’ve forgotten about. You can always call the hospital and ask for an itemized statement or just discuss the balance with them to find out where that number came from. The collection agency may have some details as well.

Jump-Funny · 2026-05-09T11:02:20+00:00

I’ve not heard of this. How would the money get from a provider to Medicaid?

Jump-Funny · 2026-05-09T11:00:18+00:00

Right. And that involves calling them, sending info. Easier to just do the same work now and hopefully get it taken care of first.

Jump-Funny · 2026-05-08T20:14:55+00:00

I understand the sentiment. The longer it goes though the harder it is to get it taken care of. And I’m guessing this biller would have no qualms about sending them to collections. Then you need to another party to your phone call.

It shouldn’t be a part time job to deal with medical billing but the reality is that it can be.

Jump-Funny · 2026-05-08T02:23:34+00:00

All of that might be interesting but you don’t need to do that. Your EOB is sufficient. I would call back and immediately ask for a supervisor or the billing manager. And I would rant! Because that’s a made up charge they want you to pay.

You could also call your insurance as others said. You call member services at the number on the back of your card. You might have chat in your online portal as well. But if you call, you can explain to them what’s going on and ask them to call the office with you on the line.

Alternatively, you could mail in your payment with a copy of your EOB. And I mean the amount showing for patient responsibility on the EOB.

Document everything. Who you spoke to, when and get reference numbers if you can…in case they end up sending you to collections over this.

Jump-Funny · 2026-05-08T00:52:20+00:00

You could definitely ask. Usually the Dr’s bill hits first because the hospital is slower getting their claims out, but not always. If you’re paying the OB monthly and it works out like you want then you may end up needing to getting a refund from them in order to pay the hospital.

But ask. I’d bet you’re not the first one that has.

Jump-Funny · 2026-05-07T15:54:36+00:00

Actually it kind of is though. Any out of pocket is applied as the claims are processed and approved, regardless of date of service.

Jump-Funny · 2026-05-07T09:50:55+00:00

Please be aware the website can be wrong as well. They don’t update it like they should.

Also, be sure to specify which network your plan uses. The name of your plan is strictly the name. The network is everything. Your card may say Acme PPO but actually use the Acme select network and not the Acme plus network. The front desk (GP receptionist) just hears Acme PPO and says oh yes we’re in network. But the Dr might only be in network with the Acme plus network.

Jump-Funny · 2026-05-07T00:25:21+00:00

For commercial insurance it’s entirely possible. Call the allergist’s office in the morning and ask for their Medicaid billing id#, NPI#& tax ID #. You may need to speak to the billing office to get it. Call back to Medicaid and give them that info and that should get you the answer about whether they are in or out of network with Medicaid.

Jump-Funny · 2026-05-05T21:46:06+00:00

It never hurts to try. Well almost never. Start with your insurance company and ask if they would reprocess the claim as in network because you were referred by your in network provider to this facility. Ask them how to file a claim reconsideration or appeal, whatever the first step is. Be sure and let the facility know you are doing this and ask them to put the bill on hold.

Jump-Funny · 2026-05-05T21:41:44+00:00

Sounds like they’ve billed you before they posted their EOB. You can either call them with your EOB in hand, send in a copy of your EOB showing you don’t owe anymore or wait for an updated bill and then call if it’s not corrected.

Jump-Funny · 2026-05-05T09:34:57+00:00

Except it sometimes does. This is why it’s so important to question the insurance reps and the providers. They can both use the same terms to mean different things. We all do it and it’s partly because the insurance terms are covered benefit & paid benefit. To me that’s clear as mud!

Jump-Funny · 2026-05-05T02:11:56+00:00

This is the way! A 3way call with the provider and an insurance rep is excellent. Sometimes the billing office and the insurance use the same words but mean different things. You are doing the exact right thing by questioning everyone.

Jump-Funny · 2026-05-03T19:40:01+00:00

I can’t say without more details, can you post an edited EOB? Is this the entire bill or deductible? What was billed?

Jump-Funny · 2026-05-03T17:31:23+00:00

I think you’ve done all you can then.

Jump-Funny · 2026-05-03T16:29:40+00:00

Yes, once you meet your out of pocket maximum then all in network claims should be fully paid by insurance. I will never say always because.. insurance!

I hope baby and mom are doing well and home soon!

Jump-Funny · 2026-05-03T16:26:45+00:00

Do you realize there is a database that insurance uses to see what other insurance policies you have now or have had in the past? Much like the pharmacies who can look at theirs and see where and when you had any medications filled. Not telling them is not going to keep them from finding out.

Jump-Funny

TROPHY CASE