r/HealthInsurance • u/Enough-Active-5096 • Aug 06 '25

Plan Benefits Colonoscopy anesthesia bill

Post image

Husband got a pre-approved colonoscopy a few weeks ago and this was the bill from the anesthesiologist? Thank god the insurance is covering/paying but wtf? Did they add an extra zero on accident? This makes me so angry.

141 Upvotes

85% Upvoted

133 comments sorted by

View all comments

6

u/West_Guidance2167 Aug 07 '25 edited Aug 07 '25

That definitely seems excessive for a colonoscopy, but the entire thing is arbitrary. They know how much the insurance is going to pay so they can put whatever number they want there. Now, if you had to pay 20% of that, then you have a very good point, but it should be covered 100%/

1

u/bobd607 Aug 07 '25

They don't know what insurance is going to pay - they submit an arbitrary excessive amount to ensure that they get the maximum payout from insurance - this saves them from having to keep track of what they have negotiated with every insurance they accept.

2

u/PraiseTalos66012 Aug 07 '25

Providers and insurance have contracts. It says exactly what the payment for everything is. It also says that the providers must give insurance a "discount" aka providers gotta charge everyone this insanely high rate and then "lower" it for insurance.

Nothing is arbitrary, not the billed amount, not the amount payed to the provider. It's all predetermined in the contract.