State: New Jersey
I am seeking help to address a medical bill of ~2K dollars for 12 physical therapy visits from mid summer of 2023 to early 2024. Before starting visits, I had submitted all my insurance details to the front office of the facility and had them confirm that my insurance is accepted and what would be my co-pay. I was told that they accept the insurance and there is no co-pay. Now one might say that not having co-pay is a red flag but I have been to PT facilities before that waive co-pay maybe because what insurance pays them is good enough for them and they waive co-pay. I thought this was the same case.
After couple of weeks, I started getting the BoE statement from Aetna saying I might owe money for the treatment. Immediately I took it to the PT office and they said do not worry, ignore the BoE statements, your treatment is covered by the insurance. Fast forward almost 6 months in early Jan, they send me a bill of 2000 dollars. When I question it, they say the therapist that has been treating me is out-of-network!!! I was shocked and said your office shows up on Aetna portal as In-network but they tell me you were assigned to a out-of-network Dr. I am baffled why would they not assign me in-network therapist or atleast tell me upfront and the costs involved of working with a "out-of-network" PT in an "in-network" facility. My co-pay is 20 bucks and max I would had to pay was 240 dollars but now I am being slapped with $2000 bill.
Since there is no written communication about this and the facility is telling me since I received the treatment I owe the money and that I should go on a payment plan. I feel this is complete fraud as I would never had gone to the facility if they said the therapist was out-of-network. How can I fight this ? I don't want this this bill going to collections and maybe impact my credit score.
I am seeking help to address a medical bill of ~2K dollars for 12 physical therapy visits from mid summer of 2023 to early 2024. Before starting visits, I had submitted all my insurance details to the front office of the facility and had them confirm that my insurance is accepted and what would be my co-pay. I was told that they accept the insurance and there is no co-pay. Now one might say that not having co-pay is a red flag but I have been to PT facilities before that waive co-pay maybe because what insurance pays them is good enough for them and they waive co-pay. I thought this was the same case.
After couple of weeks, I started getting the BoE statement from Aetna saying I might owe money for the treatment. Immediately I took it to the PT office and they said do not worry, ignore the BoE statements, your treatment is covered by the insurance. Fast forward almost 6 months in early Jan, they send me a bill of 2000 dollars. When I question it, they say the therapist that has been treating me is out-of-network!!! I was shocked and said your office shows up on Aetna portal as In-network but they tell me you were assigned to a out-of-network Dr. I am baffled why would they not assign me in-network therapist or atleast tell me upfront and the costs involved of working with a "out-of-network" PT in an "in-network" facility. My co-pay is 20 bucks and max I would had to pay was 240 dollars but now I am being slapped with $2000 bill.
Since there is no written communication about this and the facility is telling me since I received the treatment I owe the money and that I should go on a payment plan. I feel this is complete fraud as I would never had gone to the facility if they said the therapist was out-of-network. How can I fight this ? I don't want this this bill going to collections and maybe impact my credit score.