Hello,
I have a curious case here and I would really appreciate some advice.
I am with Anthem. A few months ago I got a tear in my left shoulder and I sought out an in-network orthopedist.
After an MRI, he ordered a surgery. I asked for an estimate of how expensive the surgery would be and I was told $741 which I accepted.
I assumed that they had checked with my insurance and that is how they arrived to the number. I was also handed a paper on the day of the surgery which also stated $741 would be the full out of pocket cost for the surgery.
Fast forward to 2 weeks after my surgery when I discovered that the surgery center had charged Anthem $95000 and that Anthem would not cover almost any of the chargers as the facility was out-of-network.
I received a statement from the surgery center now that states the charges of $95000, insurance paid $0 and that there are $0 adjustments. However in "balance due" it sates the original $741.
I have no idea how the surgery center arrived at this number and who is paying the rest if it isn't me or my insurance?
After asking both the Orthopedist office as well as the surgery center, I was assured that there is a special agreement that I am only being charged the "stated rate" i.e. only $741.
Can anybody explain how this work?
