Late last year, I went for a doctor's appointment with a specialist and was charged almost $1,000 for my appointment. Long story short, I called my insurance and they told me it's bc the money applied to my deductible.

    I was so scared after this and my insurance provider changed for 2026, so I called at least three different offices trying to get an estimate of how much my appointments would be. I finally was transferred to the claims office – I provided the lady with the doctor's Tax ID and NPI and someone told me I would only be charged for a copay and to call them back if the hospital tries to bill me more. The doctor has written that he is in network so I thought I was okay.

    After two appointments, I was charged about $2,000 by the hospital. I was shocked bc my insurance had told me I would only be responsible for the copay. I have the lady's name and reference number. After calling claims again and submitting a complaint, they informed me the doctor is in-network but the facility is not in network so I was charged hospital fees that my insurance would not cover.

    I'm really frustrated because I feel I was given incorrect advice by claims? My EOB says the facility was out of network so they would not cover it. But I wouldn't have gone if I had been informed I would be charged out of network fees. I specifically called for that reason.

    Can someone give me advice? Do I need to pay these fees? Or is there any way I can push back on this more?

    Claims department gave me incorrect information and now I'm $2,000 in debt
    byu/Far-Wedding-7291 inInsurance



    Posted by Far-Wedding-7291

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