I received an Estimate Worksheet from the hospital for my wife's surgery for an out of pocket amount of $887. They had all my health insurance information to put together the quote. After the surgery, which went as planned, the bill is $3315. I understand it is only an estimate, but this is way too far off. Do I have to pay this full amount?
1 Answer from Attorneys
It is very difficult to answer this question without reviewing the documentation. Often with hospital bills, the estimate may only be for the services performed by the hospital itself, and it may not contain the estimate for other medical providers (individual physicians, pathology, anesthesia, etc.). It also depends on the procedure(s) performed, whether the claim was paid as in-network or out-of network, your individual plan, etc.
Also, it is important to go off of the Evidence of Benefits (EOB) from the insurance company and not the bill from the hospital. Often times, the hospital bill does not contain the discounted amount. I suggest starting by contacting your insurance company.
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