Will I have to pay The full amount that the doctor charged or The amount that bluecross allowed?

Question

I have a feeling that I’m about to be Denied coverage for a leep biopsy because it was part of a preexisting condition(and I received a letter from BC saying that they are checking into the claim); If I am denied will I have to pay for the amount the doctor charged or the amount that BlueCross allows for that Particular procedure?

Answer 1

Usually your contract with your insurance states they will pay the allowable amount on covered charges.  If your claim is denied it will not be considered a covered charge and they will not adjust the services, so you will be responsible for the amount the doctor charged.

Answer 2

Even if coverage is denied by BCBS, because of pre-ex. conditions, if the Dr is part of the Blue Cross network.. then you would still just pay whatever the negotiated charges are between BC and the Dr. If this provider is outside of the network, then you would pay whatever the Dr. charged.

Answer 3

What the Doctor charged is what you are liable for.