(01-31-2019, 01:28 AM)americus 2.0 Wrote: All I can say is, when I was new to my current insurance I was not covered for a year for my preexisting condition of anxiety and depression and had to pay cash every month to see my doctor. $93 per visit. After my insurance decided I was "worthy" of coverage I had a $60 co-pay and they (the provider) charged my insurance company $255 per visit on top of the co-pay. That's over $300 for the same dang visit. Something is wrong with this picture.

I currently see an alternative medicine doctor/chiropractor who refuses to take insurance because of all the BS and red tape involved and He doesn't want insurance companies telling him how to treat his patients. He charges what a typical specialist co-pay is and that is covered by my flexible spending account.

Your psychiatrist isn't getting $255 from the insurance. I will do my best to explain. You have to bill at a high rate so that you get the max the insurance will allow. Basically its like asking for a credit card raise.

Me: Hey visa, I want a 50k credit line increase.
Visa: Ugh your income hasn't changed at all. We will give you a 3k increase.
Me: Okay

Its a bit more complicated than that. Because you have to offer the same price to any insurance, so you have to have a number that is high enough that you will never be below an insurance threshold. Your psychiatrist can charge you, as a patient, less when you pay cash as basically a paying same day cash discount (which insurance won't do, they have to billed argued with etc. etc. )

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