Question
Last month I had a medical procedure done (colonoscopy).
My deductible with Blue Shield was fully paid up for the year.
Just before the procedure, I asked at the front desk whether
I would have any further expense beyond the $100 co-pay.
They told me it would be fully covered by my insurance. All I would have to do is forward the Blue Shield payment back to the medical center when I receive it. I said OK. I received a billing statement from the medical center for $4150 and on it was a yellow sticker requesting that when I receive payment from Blue Shield I should endorse it and forward it onto the medical center. But when I got the check from Blue Shield, it was in the amount of $2900. It seems that I have to pay the difference, yes? I am not sure what to do. I was led to believe the procedure was covered fully. Is it wiser for me to pay the difference ($1250) and then take it up in small claims court, or not pay the balance and let the medical center go after me for the it?
Answer
Hi David!
If they told you that the Blue Shield payment would be your payment in full, I would endorse over the check you were sent and mail it to them.
And hopefully that will be it. Some providers will accept insurance payment as payment in full so hopefully that is what they will do.
If they bill you the balance, I would fight them on grounds on giving you false information.
Good Luck!
Tricia
