I don't think we know enough about this particular situation. It does sound sketchy, but there are also plausible reasons for what happened. As a personal example, I saw my podiatrist in my HMO network for an issue. He sold me discounted off-the-shelf orthotics. He never submitted that bill to insurance, nor would they have paid it. He also suggested custom orthotics. He offered to see if insurance would cover it first. They declined. He then said he could still do it, but I'd have to pay out of pocket. I declined. He was not required by the insurance contract to submit the custom orthotics first. He could have just offered to sell them to me.
The unscrupulous part is that if the provider knows a charge would not be covered by insurance, he should be telling you so up front and asking if you still want the service. It's possible this was in some fine print in something you signed.
The unscrupulous part is that if the provider knows a charge would not be covered by insurance, he should be telling you so up front and asking if you still want the service. It's possible this was in some fine print in something you signed.
Statistics: Posted by toddthebod — Wed Mar 27, 2024 10:13 pm — Replies 27 — Views 1188