That's your "responsibility," according to Lisa Norris, co-president of the patient advocacy group Alliance of Claims Assistance Professionals.
"It's not fun going through all the insurance information," said Norris
For a service that costs $300, "you have to pay $300 before you leave the office," said Norris
"You then send the paperwork to your insurer."
Your insurer may say they'll reimburse 50% of what you pay for an out-of-network visit.
But even that doesn't mean you're getting back $150, warned Norris
, because the insurer may only pay for what's called an allowable amount.
said the allowable amount can be based on what the insurer would have paid an in-network provider for the same service.
"If the in-network doctor was paid $100 for an office visit, then based on that rate, you will get back $50 for going out of network and you have to pay the balance of $250," she
Covered vs. not covered: Your doctor may be part of your plan.
But the services or specialists he
recommends may not.
If you think you are being billed more than what you owe according to your benefits, immediately point it out to your insurer and your doctor, said Norris