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Allowed Amount Greater Than Billed Amount

I am, fairly, new to this forum and I just want to ask for any opinion from anyone. My son, recently, had gone through EKG in a hospital. I was surprised when I got the bill. I had to pay $1,109.12 for just the EKG. I know it costs more in a hospital but the thing is, the hospital's billed amount is just $180.75 based on the COB. I talked to the customer service representative and she told me that this is due to the allowed amount, $964.25, being greater than the billed amount. I don't know if that makes sense. The hospital just billed my insurance, which is United Healthcare, for $180.75, but because my plan's allowed amount is $964.25, I have to pay $1,109.12. It appears that I have to pay the sum of the billed and allowed amount. Is this a usual practice of health insurance companies? Any advice will be helpful. Thank you.
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replied March 23rd, 2015
I'm new as well but glad to jump in. It sounds like the terms are getting interchanged a bit. It also sounds like you have an HMO and went to a hospital that isn't part of the network or you have a PPO. This billing isn't uncommon. We're getting to a point where health care shopping will become more commonplace simply due to the incredible difference in costs depending on where you go and the relationships providers have with insurance companies. The other thing to keep in mind is that, depending on household income, there may be some ability to negotiate the remaining cost with the hospital and even work out a payment plan. Good luck!
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