r/HealthInsurance • u/Antique_Ad3823 • Jan 26 '25

Employer/COBRA Insurance $20K colonoscopy, when dr’s billing office said $50 in email?

Had a colonoscopy by an in-network doctor, at their own surgery center. Before the procedure I spoke with the doctor and billing office to make sure it was all in-network. They confirmed in writing via email, explicitly said I’d only be responsible for my $50 co-pay, with no out-of-network charges.

Weeks after I get 2 denial EOB letters from my insurance, saying the surgery center and anesthesiologist are out of network, and I’ll owe $20K. After some googling it looks like the surgery center and anesthesiologist aren’t in-network with any insurance!

What is happening? Will the doctor’s office really come after me for $20K, when in writing they said I’d only be billed for $50? If so, what can I do? I’m not sure if No Surprises Act will cover this.

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u/aBloopAndaBlast33 Jan 26 '25

I definitely wouldn’t pay the bill, but I don’t have advice on how to go about getting it cancelled. Sounds like the kind of place that will send to collections and threaten your credit.

In the future, if your insurance says they aren’t going to pay for something, don’t do it.

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u/scarykicks Jan 26 '25

Thought medical doesn't go on your credit report anymore

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u/mardi__blah Jan 26 '25

Right, they just can still get an order for wage garnishment, etc.

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u/aBloopAndaBlast33 Jan 26 '25

Yea maybe I mis-spoke about credit. Didn’t that change recently ?

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u/Evamione Jan 26 '25

Yes but only medical bills under $600 don’t go on credit reports. Bigger bills still can.

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u/radishboy Jan 27 '25

Call whoever sent you the bill and tell them you would like to apply for “financial hardship.” That’s basically saying “I cannot afford to pay this.” So you will send them some information and they will look at it and they will say “we agree; you cannot afford to pay this. And then you will get a letter in the mail stating “upon further review, we have concluded that you don’t need to pay for this anymore” Or worst case scenario your discounted bill will be a fraction of what they were asking originally.