[Graybeard58]

The example you showed is perfectly legal, you'd owe $100. I have a $300 deductible on my insurance, until I have met that, I pay all bills and they appear the way you show. After my $300 deductible is met, I pay 20% and insurance pays 80% until I have paid my max out of pocket of $1,000 after that my ins pays 100%.

Everything appears on the up and up with yours.

If you had no ins, you would owe the entire $500 in your example, if you were on medicaid you'd owe $0. I know there's something wrong with that but that's the way it is.

[Terry Mross]

This was my wife’s bill and she had an “account” that was supposed to pay it. You argue with the insurance company for months and in the mean time your credit is damaged. I’ve been told by people who work at insurance companies that they automatically refuse to pay a certain percentage of all claims.

If they want health care reform they should reform the billing. If a hospital is willing to accept 40% they should bill 40%. Two men are in the same room having suffered heart attacks. They’re both billed $100,000. One of them has insurance and the hospital accepts $40,000. The other guy does not have insurance and owes $100,000. This should be illegal. Bottom line is if the provider is willing to discount it for the insurance company he should be willing to discount it for me.

I do know that you should never pay cash for a medical procedure. Let them bill you then they’ll negotiate. If you pay up front they want it all.