r/HealthInsurance • u/PromotionAgile • 9d ago
Plan Benefits High charge at urgent care
I was charged $900 for a 15 minute visit to urgent care. Insurance doesn't cover any of it because I have a high deductible plan. I called the medical practice saying the charge was ridiculous. They checked the billing codes and found no error.
They said the insurance company sets the price and I can file a grievance with insurance. That seems like a wild goose chase.
Why is it so expensive? Is there anything I can do to reduce the cost?
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u/LizzieMac123 Moderator 9d ago
If your EOB from insurance says your fee is $900, that's the fee.
Urgent Cares are more expensive than a PCP/specialist but less expensive than an ER.
A provider doesn't always have to charge you the full amount from the EOB, but they are entitied to. My last urgent care visit on an HDHP plan was about $700 and it literally involved them telling me to go to the ER, they couldn't treat what I had.
There is no magic way to reduce the cost if it was coded correctly-asking for a detailed bill only works if something is wrong (wrong charges, charged twice for something that only happened once, etc.) You can always try to negotiate, but it's up to the provider as to if they are willing to negotiate. Most providers offer payment plans too. But none of us would be able to tell you if your provider does any of that, you'll just have to call and ask. Asking for a paid in full discount sometimes works too... "if I offered to pay you $500 now to settle this, would you consider that" of course, that means being able to then pay that agreed-upon amount right then.