United Healthcare price Estimate Cost glitch?
I have a United Healthcare Choice Plus plan with a deductible for $3,200 and out of pocket limit of $5,200. Earlier in March, I did my due diligence and researched podiatrists in the area for a fracture ankle. I went to Find Care & Costs > Estimate Cost > View all estimates > typed in Podiatrist. I made an appointment for my current podiatrist because her estimated what I would owe would be $40 vs a orthopedic doctor which would be around $75.
At the appointment, I asked to pay and the receptionist advised she would send me the bill. I go home and I research additional podiatrists again (I wasn't satisfied with the service) and noticed the out of pocket cost has gone up to $233. I thought this was strange and thought nothing of it.
Come this week, I received the bill of $249, plan discount of $124.21 and I owe $124.79 and it was coded as New doctor visit, 45+ minutes. My appointment was 15 minutes.
I didn't think to take screenshots when I was researching. Was this overnight increase due to the security hack? I understand I am at fault because I didn't get the cost in writing prior to the appointment but the estimated cost tool has always been accurate for me before. It accurately told me the cost of my MRIs and XRays depending on the facility I selected that month so I didn't think the estimated cost tool would fail me.
Is there action I can take? I'll take this as a learning opportunity for the future to confirm the cost.
Sidenote: Injuries are expensive. Primary care doctor, X-Rays, MRIs, CAM boot, crutches, knee scooters, shower chairs, Podiatrist, second X-RAY to ensure bone has healed, physical therapy
I know there was new legislation passed in my state.
2023 Florida Statutes
Title XXIX – Public Health
Chapter 395 – Hospital Licensing and Regulation
Part I – Hospitals and Other Licensed Facilities (Ss. 395.001-395.3041)
395.301 – Price transparency; itemized patient statement or bill; patient admission status notification.
(b)1. Upon request, and before providing any nonemergency medical services, each licensed facility shall provide in writing or by electronic means a good faith estimate of reasonably anticipated charges by the facility for the treatment of the patient’s or prospective patient’s specific condition. The facility must provide the estimate to the patient or prospective patient within 7 business days after the receipt of the request and is not required to adjust the estimate for any potential insurance coverage. The estimate may be based on the descriptive service bundles developed by the agency under s. 408.05(3)(c) unless the patient or prospective patient requests a more personalized and specific estimate that accounts for the specific condition and characteristics of the patient or prospective patient. The facility shall inform the patient or prospective patient that he or she may contact his or her health insurer or health maintenance organization for additional information concerning cost-sharing responsibilities.
submitted by /u/hoperoulette
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