Hi,

my insurance company does not cover infertility services. I was fully aware of this and expected to pay the services for my husband at his urologist. My insurance company sent me the statement showing that they denied the claim. On this statement they showed the amount that would have been owed by them after rerpricing if the service was covered. However, the patient portion listed the full amount with no repricing.

I called the doctor office and asked why I am being charged the full amount and not the repriced amount, after all they are in the network that my insurance covers. She told me that they are only going by what is on the insurance company's statement under "patient portion" so that is what they billed me.

I have left a message for my insurance company but have not heard back yet. Has anyone else come across this? I am just trying to find out if I have a chance of paying the repriced amount instead of the full amount. The doctor's office said they would be more than happy to bill me the repriced amount but they have to go by what the insurance company has on their statement. I am wondering why the insurance company would care what I owe since they are not paying for it at all anyway.

Thank you for any input!