r/HospitalBills • u/YoungRustyCSJ • Mar 01 '25
Hospital-Non Emergency Question For The More Experienced…
My daughter got an MRI last month and had to be anesthetized because she’s still a toddler. We received a bill for $800 in the mail this week. We have full coverage through my healthcare through my employer(UMR).
Do we need to call the hospital and ask for an explanation or should we just dispute it out right? Is it likely that we just owe this? Is this the place for these questions? I don’t know but my wife told me to ask Reddit for their opinion.
Please help!!
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u/Intelligent_Royal_57 Mar 01 '25
What's your deductible? I have excellent insurance and had an endoscopy. My deductible is $1,000. That what my bill basically was. So now I pay co-insurance which my share is 20% until I hit my out of pocket max which is $3,000 and then they pay 100%.
Even if you have insurance you still have to meet your deductible.
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u/Trolleyes84 Mar 01 '25
You need to check your policy with a fine toothed comb. When my daughter had a dental surgery done because she was under 9 years of age the insurance would pay for anesthesia at an outpatient surgery center. Once she was over 9 they would not. If you have a toddler who cannot safely have the imaging without the sedation you may have a case.
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u/CallingYouForMoney Mar 01 '25
Call your insurance.
On another note, did you know dogs cannot do MRIs? But catscan
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u/Active_Cod_8538 Mar 01 '25
It’s the beginning of the year, most likely you haven’t met your deductible and certainly haven’t reached your max out of pocket. Your insurance card sometimes says right on it how much your deductible is, or log into your online insurance account and you’ll be able to see your deductible there. Also, whether you have an HMO or PPO will change how claims are paid and what’s covered.
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Mar 01 '25
Call ur insurance carrier. You went to an approved provider. If u were then billed by someone out of network within that facility they will likely cover it as a surprise bill. If u did not get pre approval, you may have to pay but they will often work out a reasonable payment. The best thing is to call ur insurance company carrier and see what they say. They’ll know ur policy and their responsibility along with urs. Hope ur kiddo is okay and good luck.
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u/Critical-Crab-7761 Mar 02 '25
Never pay the first bill. Always wait to receive an explanation of benefits from your insurance provider. It will show the total charges, the insurance's negotiated price, and what you should be responsible to pay for.
You'll get a different explanation of benefits for each bill you receive. Example: hospital services, anesthesia, imaging service, Doctor would each get an EOB, so 4 different EOB with what you owe to each provider.
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u/dumb_username_69 Mar 01 '25
What does the EOB from your insurance say?