Quote Originally Posted by Edwina's Secretary View Post
But that is true with "private" insurance as well. My Explanation of Benefits show the "full price", the discount price my carrier has negotiated, the amount they will pay and what I must pay.

The difference and there is always a difference - is "lost" as you say.

When I see my PCP doctor my copay is a percent of what the insurance covers. As the doctor does not know how much this is...I pay nothing at the time. My doctor send the bill to the insurance company - they decide what they will pay - send that back to my doctor and them he must send me a bill for my percent of the bill.

I have tried to pay something at the doctor's office but it cannot be done that way. I must wait...and so must my doctor!

We switched, once again, health plans. LOL, same deal- way less coverage for much higher premiums. They pay the first $2000, I pay the next $3000. Yeah, I was at that $3000 figure by May. May! Anyhow, I went into my doctor for what I KNEW was a sinus infection. Knew it, knew it, knew it. Of course, antibiotics were prescribed. As I left, I asked for a copy of my bill, so that I could maintain my own records at home as to the $3000 payments. The clerk said she had NO IDEA WHAT THE CHARGE WAS! I was stunned. I just had a service at an established doctor's office and they couldn't tell me what my bill was ? WTH? I stared at her, and she said just what ES said, and that I would get a bill within 8 weeks. LOLOL. CRAZY!