What is the name of your state? Texas
As the title of the thread suggests, my wife and I recently discovered that we are pregnant. We have insurance with Cigna. We have a $500 deductible and the plan covers 80% after the deductible (up to the out-of-pocket max). Pretty basic stuff, right?
We have been to a doctor twice (we'll call her Dr. Wrong). The first visit, as specified by the insurance company was simply a $20 copay. On the second visit, they tried to get us to sign a prepayment contract. These were the terms:
Total Expense: $1975 (maximum allowable amount)
20%: $395
Deductible: $500
Total Due: $895
After reading the contract, I approached the lady and told her that I thought there was a mistake. The $500 should come off of the Total Expense before you take the 20%. The deductible is not some kind of extra fee, but rather full payment for the first $500 of the expense. Her response was simply, "We've been doing this for 10 years." I did not sign the contract.
I have since confirmed with Cigna THREE times that my understanding is correct. I've even had Cigna call the doctor's office. They told the Cigna customer service rep (in a not so polite way) that they basically didn't care what she said and they were going to do it their way. We have also received a letter from the doctor. In summary, it says, "This is how we do it. Feel free to use a different provider."
My wife and I probably will end up using a different provider, but none of them seem too excited about taking her as a patient because they know we are switching providers and they think we will be trouble makers.
Am I missing something? I know it's not really a lot of money, but can Dr. Wrong really do this? If not, what should I do?
As the title of the thread suggests, my wife and I recently discovered that we are pregnant. We have insurance with Cigna. We have a $500 deductible and the plan covers 80% after the deductible (up to the out-of-pocket max). Pretty basic stuff, right?
We have been to a doctor twice (we'll call her Dr. Wrong). The first visit, as specified by the insurance company was simply a $20 copay. On the second visit, they tried to get us to sign a prepayment contract. These were the terms:
Total Expense: $1975 (maximum allowable amount)
20%: $395
Deductible: $500
Total Due: $895
After reading the contract, I approached the lady and told her that I thought there was a mistake. The $500 should come off of the Total Expense before you take the 20%. The deductible is not some kind of extra fee, but rather full payment for the first $500 of the expense. Her response was simply, "We've been doing this for 10 years." I did not sign the contract.
I have since confirmed with Cigna THREE times that my understanding is correct. I've even had Cigna call the doctor's office. They told the Cigna customer service rep (in a not so polite way) that they basically didn't care what she said and they were going to do it their way. We have also received a letter from the doctor. In summary, it says, "This is how we do it. Feel free to use a different provider."
My wife and I probably will end up using a different provider, but none of them seem too excited about taking her as a patient because they know we are switching providers and they think we will be trouble makers.
Am I missing something? I know it's not really a lot of money, but can Dr. Wrong really do this? If not, what should I do?
