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Medical health insurance bill?

I have united healthcare ppo insurance. max out of pocket $5000. I had out patient surgery in out of network hospital which the insuranse suposed to cover 60% of the cost. The Hospital bill was 7120$ and the insurance only pays 1078$ which meens I have to pay 6041$. Their explanation was: the amount allowed for that type of surgery was 1974$ and they will cover 60% of that alowed amont which is 1078$. What can I do to pay less? Is there any chance??

Public Comments

1. No, you should have gone with a hospital that was in network, the only thing that might save you is if there was no hospitals within you network that did the procedure. You would have to have letters from your doctor, and the hospital sent to United Healthcare but the chances are slim to none on getting it approved for more. Sorry
2. Don't go out of network next time. Did you try negotiating?
3. I would look at your plan carefully. Insurance companies sometimes have a way with sticking you with a bill they really should have paid. The reason out of network coverage is poor (60%) is because they know they won't get a discount from providers who are out of network. Sounds like they paid 60% of what would have been the contracted amount with the hospital if they were in network, rather than the actual amount. Does your contract say they will pay 60% of out of network fees or 60% of their allowed amount (which I have never seen). There may also be an out of pocket max for out of network services. You need to look at that and look at the working in the explanation of benefits and fight with them if they are cheating you. Call the hospital if there is financial hardship and see if they will reduce your bill but do not send them a penny unless you get it in writing. Otherwise they take your money and stick you with the rest of the bill and send it to collections.
4. make use of the SE like google or yahoo to get some ideas first if you want to get the massive information,however if you do not want to spend so much time,here http://www.HealthInsuranceIdeas.info/free-online-health-insurance.htm is a direct and good resource for your questions.
5. It is very tough to not get stuck with some hefty bills when one uses and out of network medical facility. Big companies have tremendous bargaining power and can arrange for some very low rates on medical services for their members when they use an in network facility but of course if they decide to go out of network then the insurance company's hands are tied because they do not have a contract with that particular facility. You may want to try and negotiate directly with the hospital yourself. Explain your situation and see if they can give you something in writing that will reduce the amount you have to pay. Other than that, you might want to just set up a repayment schedule with them to slowly pay the bill off month by month (not the best thing to hear I know but at least you can avoid being sent to collection and hurting your credit score).
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