Illegal to not bill through insurance?

[u/MenuRare9880]

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.

[u/Emotional_Wheel_7140]

Tbh no one is going to look into this office for offering lower prices to cash pay patients. You didn’t have insurance so they gave you a cash option. But they obviously are raising the prices for people with insurance because they know insurance isn’t going to pay much anyways, so it’s how they fix the difference. The moment you have your insurance they could no longer offer you that low price because they are in contract with that insurance for a higher payout. It should be okay for offices to offer lower cash prices. But it technically should only be a 10% difference. So now they can’t allow your record to be able to play that cash price because if they ever get audited by the insurance company you use they could be charged with fraud and face jail time and lost license . Unfortunately practices are trying to offer lower prices for cash patients because they don’t cost the staff time chasing insurance. But once insurance finds out they are offering cash patients lower prices than to them they will come for that office and it is illegal.