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General => General Discussion => Topic started by: MetalJunkie on January 04, 2018, 09:00:41 PM

Title: Medical insurance explanation?
Post by: MetalJunkie on January 04, 2018, 09:00:41 PM
So I'm looking to do a sleep study. The estimated total cost is 7410 and my insurance will pay 5580 of it, leaving me with an 1830 out-of-pocket cost.

When I schedule this sleep study, are they going to want to 1830 paid for on the spot? Or do they file the claim, and send me the bill for what isn't covered by my insurance? Because I can pay off 1830 over a few months, but not all at once.
Title: Re: Medical insurance explanation?
Post by: KevShmev on January 04, 2018, 09:19:28 PM
First off, how in the world is the sleep study that expensive??  I did one two years ago and it wasn't even close to that much.

Second, most places like that will let you do 12 months, no interest, especially when what you owe is that much.  Once you get your first bill after the insurance pays what they will, there should be a number on there you can call to work something like that out.
Title: Re: Medical insurance explanation?
Post by: Cool Chris on January 04, 2018, 09:27:16 PM
Third, do NOT ask for medical insurance advice from some metal heads on a music forum. Talk to a professional, someone who does this for a living. :-)
Title: Re: Medical insurance explanation?
Post by: PowerSlave on January 04, 2018, 10:33:56 PM
Much like Kev, I had one of these done several years ago. There's no way in hell it should cost that much. In fact, if memory serves me right, it cost me next to nothing.
Title: Re: Medical insurance explanation?
Post by: Spiritus on January 05, 2018, 12:09:59 AM
Damn, are you sure you aren't being scammed. Sure as hell feels that way. Crazy.
Title: Re: Medical insurance explanation?
Post by: El Barto on January 05, 2018, 08:28:08 AM
Call the people doing the study and ask them. They're the ones you'll be paying the money to. And personally, for anything more complicated than a routine checkup or a flu shot, I always wait a month or two before paying any medical provider. Sooner than that and they're not entirely clear on who's paying for what.
Title: Re: Medical insurance explanation?
Post by: Grappler on January 05, 2018, 08:34:15 AM
Or do they file the claim, and send me the bill for what isn't covered by my insurance? Because I can pay off 1830 over a few months, but not all at once.

That is usually the way things work.  You can always call a medical provider and try to negotiate a payment plan. 
Title: Re: Medical insurance explanation?
Post by: dparrott on January 06, 2018, 09:01:29 PM
Third, do NOT ask for medical insurance advice from some metal heads on a music forum. Talk to a professional, someone who does this for a living. :-)

I don't know if he's off base asking it here, I consider most of you to be the most knowledgeable and articulate people I know.  I definitely feel out of my league intelligence-wise here.
Title: Re: Medical insurance explanation?
Post by: SoundscapeMN on January 07, 2018, 11:32:41 AM
you should be able to finance it.

Call your insurance and explain that.

My issue is when getting services, the providers and your insurance should communicate to you  the Billed Amounts (or estimated) before even having the services done (so you know what the cost is ahead of time). A lot of it comes down to being In-Network and what your plan requires as far as Out of Pocket (Deductibles namely).

Ironic for me as this is the very thing I do for a living (adjust medical claims including Cost Share at times), but I have learned with a number of medical treatments over the last few years, to try and meet the Annual Deductible  before years end (or schedule things before the end of the year). Unfortunately, a lot of Specialists get backed up easily and it's not possible, so I end up paying a good chunk of my Deductible early in the next year.
Title: Re: Medical insurance explanation?
Post by: pg1067 on January 08, 2018, 01:18:36 PM
So I'm looking to do a sleep study. The estimated total cost is 7410 and my insurance will pay 5580 of it, leaving me with an 1830 out-of-pocket cost.

When I schedule this sleep study, are they going to want to 1830 paid for on the spot? Or do they file the claim, and send me the bill for what isn't covered by my insurance? Because I can pay off 1830 over a few months, but not all at once.

The only way to get your question answered is to ask whomever is conducting the study.  One thing to keep in mind:  for ANY medical issue, you (the patient) are liable for 100% of the provider's bill, regardless of your insurance.  If your insurance doesn't pay, you're on the hook, and it's YOUR responsibility (not the provider) to ensure what your insurance will and won't cover.
Title: Re: Medical insurance explanation?
Post by: Tick on January 09, 2018, 02:14:53 PM
Third, do NOT ask for medical insurance advice from some metal heads on a music forum. Talk to a professional, someone who does this for a living. :-)

I don't know if he's off base asking it here, I consider most of you to be the most knowledgeable and articulate people I know.  I definitely feel out of my league intelligence-wise here.
I agree. Some very smart people on this forum.
Title: Re: Medical insurance explanation?
Post by: Dublagent66 on January 16, 2018, 02:38:30 PM
Uh, sleep studies cost that much?  I'd get a 2nd opinion.  If you're just being tested for sleep apnea, there's no way it costs that much.  If the testing is much more extensive because of an unknown sleeping disorder, who knows?  Still can't imagine it costing that much.