insurance help?

Question

my husband went to the eye doctor yesterday for the first time receptionist took the insurance info and we took a seat and waited fast forward he is through with testing the receptionist saids that will be $155.00 well we were floored his copay is $15 when we relayed that to her and asked why did you take our card / and that we were not prepared to pay that amount and we would pay the copay she said getting the card info if my husband needed surgery or something thats what the card was for and that they don't except it for routine visit well my husband paid a $100 because doesn't want his name going to a credit company for not paying i would not have been so quick because we should have been told before being seen so we could make that decision i think this was very deceptive she should have told us they don't except that card is there anyway we can get some of his money back what recourse do we have very very shady business he stiLL owns $55

Answer 1

First make sure eye doctor visits are covered under your policy- and if so, how often are you allowed one. (Some plans only allow one every two years or so.)

Secondly, make sure you went to an in-network doctor. If you saw an out of network or non-preferred doctor, you probably have a deductible - which is the $155.

If neither of these apply - Try submitting the claim to the insurance yourself - member services at the insurance company will tell you how to go about this. Let them re-imburse you. I would call the eye doctor and speak to the office manager. Let them know that it really is their responisibilty to make sure they accept your plan for services and you feel it was deceptive of them to not notify you BEFORE services were rendered that you might have to pay. (Besides, your insurance might have paid them should the doctor's office billed them.) If they insist you owe them the $55, tell the office that you have submitted the claim to your plan on your own and will pay them the difference when you get reimbursed by the insurance.

Answer 2

Check the insurance POLICY and determine if it does, or does not, cover the eye doctor.

If it does, submit a claim to the insurance company for reimbursement.

(Pay the other $55 to the eye doctor in the meantime.)

Answer 3

Contact your health insurance company. There may be coverage under the policy for the eye doctor. I know when I go in they always submit it to my health insurance.

Answer 4

I'm sorry, what's the question?

If he was at the eye doctor for a medical reason, like glaucoma, then the health insurance carrier should pick it up. If it was for a vision check, like glasses, then it's a seperate coverage - vision coverage, NOT health coverage.