Has anyone experienced this? Ins Comp related

I had an endoscopy back in May. The anesthesiologist billed my insurance company for $2250.00. My insurance company felt that an appropriate fee that he should have charged was $1345. (based on an average and what they feel is "reasonable and customary". So the Dr. is now billing me for the $904 difference.

Do I even have an argument here?


ETA- I spoke with the billing dept for the Dr and they told me just to write on the bill "Please accept the insurance payment as paid in full. I will not pay the balance as I was not informed that the Dr was not participating with my insurance" and they will just accept that. Um. Ok. It can't be that easy.

Message edited 7/12/2010 1:22:34 PM.

Re: Has anyone experienced this? Ins Comp related

Someone just recently told me something like this too. She called the doctor's office and said the insurance company paid in full and it was done with. DO NOT PAY IT.

Re: Has anyone experienced this? Ins Comp related

if the dr is not participating in your plan, technically he does NOT have to accept the ins pmt as pmt in full.

I would do what they say and make photo copies and SAVE it just in case.

and I'd mail it return receipt requested. JIK