r/HealthInsurance Apr 28 '25

Claims/Providers Illegal to not bill through insurance?

I just got insurance for the first time in 3 years. My treatment that cost me $190 cash (self-pay) is now $520 until I meet my $3,500 deductible which would take me 11 months, soo.. pointless.

I told my Dr’s office I am no longer going to go through my insurance & the billing lady said that’s illegal… I am going to look for a new Dr now anyway but is there truth to this? Would I face repercussions as an individual patient if I simply chose not to disclose that I have insurance & pay the cash price?

FYI: the self-pay price was NOT subsidized by a grant or aid.

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u/LuluGarou11 Apr 29 '25

Haha no it is not illegal. Billing lady is misinformed/incorrect. This is common practice. Maybe talk to a supervisor of hers at the practice who knows better. Best case this doctors office has a policy where they refuse to take self pay, but not because it is illegal or not commonly done. Worst case billing lady is not only wrong but also aggressively wrong.