Scan Medical Insurance

I had a question about annual deductibles....?

I had 2 medical procedures done in the same year (2 months apart). I had been on the insurance for a few years (United Health Care Group). They are having me pay in full for the 1st x-ray (statement says they are counting it towards my annual deductible) and then they are paying in full for the 2nd identical x-ray at the same IN-NETWORK hospital stating that it's a covered expense. I phoned UHC & they say both procedures were under the correct limits to be covered but when the case is reviewed it comes back as my responsibility. Both instances were filed under the hospital billing side. I just don't understand why they decided to pay for one & not the other. I have spoken with other United Healthcare Members that have had the same situation occur & they also don't understand UHC's methodology of selecting when to charge an identical covered in-network procedure (in the same business year) towards the annual deductible.

Public Comments

1. Well since they were in the same year, is it possible that you met the deductible before the second x-ray was billed to them?
2. ~~The only thing which makes since to me is you have reached your deductible amount somewhere prior to the second procedure. Therefore it would be covered at the negotiated rate. Call UHC and ask them to send you EOB"S (explanation of benefits) for each procedure. Then you can see and understand exactly how it was covered.~~