Last year I was pursuing fertility treatments. My insurance covered some of the initial work up and then didn't cover anything (which was not a surprise it was mentioned in the coverage)... but the bills showed up in a really chaotic form and suggested that the insurance company was still negotiating some kind of discount so I just assumed that the care was supposed to be that expensive.
Until the doctor mentioned doing another procedure and gave me the out of pocket price. It was shockingly low. So I asked what they charged out of pocket for the monitoring appointments.
Turns out I'd been paying 2-3 times that on these "discounted" bills through insurance (which was denying the claim in full). I was livid, but figured I'd got got on everything already on a payment plan and immediately contacted the billing department asking to pay for the other remaining appointments out of pocket in full. At the time they said they couldn't do anything because the bills were still being processed.
Now a few of them have collected and some of the later ones even went UP in price. (With new codes.) They're itemizing time for the same doctor twice even though they stand there and look at the ultrasound and make decisions on the spot during the same appointment.
More importantly, the itemized bill for the SAME appointment when I started paying out of pocket is very different. One for the doctor, one for the hospital imaging. NOT three different charges.
I'm fully willing to pay out of pocket, in full. But I feel like it's insane that the same process gets coded differently depending on who pays for it. Seems like this is also a reason why my insurance premiums are so high. (Frankly, seems outright fraudulent, but I have enough on my plate.)
Obviously my first step is going to be to offer the reduced amount to the billing department. It's more than they'll get selling it to collections, right? It's clearly an amount that covers the actual costs and a profit margin as well.
Are there any further steps I can take to dispute owing multiple times the full out of pocket price if that fails? (Not expecting legal advice, but since it may be relevant, yes it's more than $500 overall, but it's not more than $500 per appointment. I'm in Ohio.)
Also, is there any limit on how long they can wait before adding a newly discovered additional charge for an extra provider that wasn't previously mentioned on the other bills? They're "finding" stuff I owe them from nearly a year back and adding it on.