using out of netwok dr, 80/20

[ctarantino 13]

Im scheduled for surgery next month. My insurance is Empire Government. My insurance says I need to pay my deductable $388. then they pay 80% and I get the 20%. The dr office says I will pay nothing but my deductable and I am worried I will have to pay the whole 20%. It is 100% covered if I use an IN network doctor. I really LOVE this dr. am already scheduled with him and dont want to walk away now. Any thoughts or experience with this??? How come my dr's office will cover the 20%??? HELP please Thanks in advance for any thoughts, ideas, or suggestions.

[Rachel412 116]

The doctor's office is probably offering to cover the 20% because they make a lot more money submitting the surgery through insurance than they do from people who pay out of pocket. Therefore, they want you as a customer and are willing to lose 20% of the insurance company's payment to them.

If I were you I'd stick with the surgeon you love but get their offer to cover your 20% in writing!

[ctarantino 13]

Thank you so much!! I really appreciate the response. I feel much better and will get it in writing abou tthe 20%. Have a great week!!!!

The doctor's office is probably offering to cover the 20% because they make a lot more money submitting the surgery through insurance than they do from people who pay out of pocket. Therefore, they want you as a customer and are willing to lose 20% of the insurance company's payment to them.

If I were you I'd stick with the surgeon you love but get their offer to cover your 20% in writing!