Ok so... to have my surgery I had to pay the cash price for the assisting doctor which was $ 400.00 and was guaranteed that once insurance paid his fee then I would be reimbursed the $ 400.00. So I call my surgeons office today since I knew they had been paid from my insurance company. They proceed to tell me that I owe them money... They couldn't explain why and would call me back tomorrow on that. I owe them the money AFTER keeping my $ 400.00. My insurance paid everything it was supposed to! If they refuse to reimburse me then I'm canceling my follow ups for the rest of the year which should cost them roughly a grand and will follow up with someone else. In the words of Sweet Brown, "Ain't nobody got time for that!!"

DO NOT agree to pay anything above and beyond your deductible and coinsurance or copay. That is balance billing and it is illegal almost everywhere unless you are out of network...and then they can only balance bill you for the difference between what the insurance paid and what they normally would pay (example if they normally pay 80% but only pay 60% out of network, they could bill you for.hour normal 20% plus the 20% difference).

They are in network.

Then they need to bill insurance correctly and refund you your $400 per your agreement.

And actually, in your state, you would complain to the medical board. There is information in this document about balance billing in your state (and it specifies that it is for out of network providers/facilities only) with links at the bottom who to complain to.

http://www.tdi.texas.gov/consumer/cpmbalancebilling.html

I sent the person over this the following email - think it will work?

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XXXX,

I paid Dr. L's cash pay price as a DEPOSIT which was guaranteed to be refunded after insurance paid. I did more research and it appears that what you guys are doing now is balance billing by holding the $ 400.00 hostage. This is not allowable as both Dr. L and Dr. P are in-network providers as verified with my insurance plan. I will expect the $ 400.00 to be refunded asap. If Dr. P does not allow the refund after you speak with her on Monday, then I will contact the Texas Medical Board and United Healthcare. I'm not trying to get nasty, but I do expect you guys to uphold your end of the agreement. I don't have an excess of money and borrowed the $ 400.00 on good faith that it would be reimbursed as promised once insurance paid - and they have.

Even if it doesn't work immediately at least it's in writing so your paper trail is started. Good luck getting it resolved.

Agree with Mizzz...it's def a good starting point. I hope they do the right thing and refund you right away. But if not, you've got your ducks in a row to start a complaint.

If they don't refund, sick your bank on them. Call the fraud department and have them investigate