You might really be asking two questions here.
1. Is it legal, as in can the provider find himself with criminal charges for doing it
2. Does the Insurance Company permit it? Could the provider lose his HMO or PPO contract?
Clarification of DHS Copay Guidelines Providers cannot deny services to recipients unable to pay a copay. A provider must accept a recipient's assertion that he or she is unable to pay a copay and cannot require additional documentation of inability to pay. An unpaid copay is considered to be unpaid debt, and the provider is not required to continue to serve recipients with outstanding debt. If it is the provider's general practice to refuse to serve all individuals with outstanding debt, and the provider gives the recipient advance notice and a reasonable opportunity to pay the debt, and the recipient does not pay the copay(s) owed, the provider can then refuse to provide care. Recipients retain the ability to seek services from other enrolled MHCP providers. Providers may choose to continue to serve recipients who are unable to pay the copays. Note: If the recipient is unable to pay the copay, providers may accept payment of the copay on behalf of the recipient from another source.
for more information see www.steveshorr.com
Even in the Minisota rules - it appears the provider cannot waive fees, except under special circumstances
When a doctor or hospital sends a bill to an insurance company, the insurance company in turn sends them an offer of a lesser amount to pay the bill. The doctor or hospital then decides whether or not to accept the offer or "assignment." Most of the time they accept it so they can get paid without any problems.
You need to check with your doctor to get a more accurate price as far as cost to you for this surgery. Cost all depends on what type of insurance coverage you have, what they cover, and what they won't cover. Sometimes if you are lucky you can get it 100% covered by your insurance company including the cosmetic surgery afterwards to remove the excess skin that will be left behind if your doctor deems your surgery medically necessary.
Some insurance companies do cover breast reduction surgery. You have to contact your insurance provider and ask for details or if you go to your family doctor/chiropractor they can let you know your options and write you referrals for the insurance company. I had reduction surgery and my insurance (Blue Sheild PPO) covered all of the costs for the reduction, both my chiropractor and surgeon wrote letters of recommendation along with pictures to back up their reasoning. I would contact your provider or doctor and go from there.
If money is an issue that is stopping you from getting bariatric surgery, then talk to your doctor. Bariatric surgery financing is usually not dealt with through insurance companies, but if the doctor can prove it is medically necessary, sometimes the insurance company will put it through. Some doctors will let patients set up a payment plan so they can have the surgery. If you own a credit card, you might want to consider putting the surgery on your credit until you can pay it off.
Surgery to correct vision can be quite expensive. However, many factor may affect the cost. Call your health insurance company to see if they offer benefits for this service. Some insurance companies will refer you to a doctor who charges lower fees. You can also lower your fees by choosing the lowest service that they offer. Most providers offer a simpler surgery for a lower price. They also charge more for blade-free surgery.
That depends on 2 factors..1. is your doctor in your insurance company's network if no then yes he/she can charge you up to the billed charges subtracting what if anything your insurance company paid. 2. Is things like labs, x-rays and procedures covered under your copay or do they apply to your deductibles and coinsurance? When in doubt contact your insurance company
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