Anonymous wrote:We are seeing it. One imaging visit with a participating provider they suckered DH into paying the whole thing upfront. EOB showed we owed $20. It took 5 months to get the refund.

At GW, by chance?

Anonymous wrote:I haven't seen this but no surprise. I've recently had a couple of providers mess up claims and bill me because "insurance didn't pay" and I got the distinct impression they were not trying hard at all to submit claims correctly or fix the issue unless I made a big stink or subtly accused them of insurance fraud.

See my post above on global services. Example crown in a tooth and they try to charge for pulp cap separately without submitting to insurance. That's already covered under the crown. Also has happened at optometrists and with other dental services.

I would say past few years for us. I know my benefits and it used to work to say I will owe $0 or $X and they'd either let me pay that or bill later. Now more providers want their higher estimate at the time of service even when I know it's wrong and explain it.

One thing I've seen happen is say you'll owe 20% but they calculate 20% of the list price instead of the negotiated price. I used to be able to explain this and they might even have looked up the negotiated price. They'll also say insurance doesn't cover something that I know it does or they want to charge separately for something that's part of a global service and not submit that line item to insurance. I insist they submit all line items to insurance and it comes back paying them $0 and I owe $0 for that service when they were trying to charge me.

Yes, and that reminds me. I need to follow up with an urgent care that billed me $150 for two separate visits where the co-pay was only 65 bucks

I haven't seen this but no surprise. I've recently had a couple of providers mess up claims and bill me because "insurance didn't pay" and I got the distinct impression they were not trying hard at all to submit claims correctly or fix the issue unless I made a big stink or subtly accused them of insurance fraud.

We are seeing it. One imaging visit with a participating provider they suckered DH into paying the whole thing upfront. EOB showed we owed $20. It took 5 months to get the refund.

I’ve only come across this with procedures, not regular office visits.

Has anyone else noticed an increase in billing charges vs. EOB discrepancies lately? Used to be that most offices would just bill me. Now, many practitioners want payment upfront. I don't mind, but it's annoying AF when I pay upfront and then need to deal with refunds (via check?!) because the practice overbilled. I paid $200 for charges that ended up being $105, and the most egregious was a diagnostic that cost me thousands out-of-pocket, but my insurance EOB said I only owed a couple hundred. I'm fortunate enough to be at a point in my life where I can afford to pay and then wait to get my money back, but I'm not happy with these little 'microloans' to medical providers. Why can't they just talk to my insurance, figure out the actual cost, and bill me once, correctly?

Seems like it only started happening recently, like the last 6 months or so. I have Carefirst (fed plan). Is anyone else experiencing this? Is it part of the enshittification of things and to be expected as how we do things now?