I used all in-network providers, and the total hospital bill came to $300,000. Imagine 360 paid $32,000 of the bill, claiming the rest was overbilled. According to the explanation of benefits, I only owe my $2,500 deductible.
This is an employer self-funded plan, and they are trying to get the hospital to absorb the balance by hiring a law firm to negotiate the claim. Meanwhile, the hospital is harassing me for the balance and threatening to send me to collections, which will hurt my credit.
I’ve never experienced anything like this; with commercial insurance like UHC or Aetna, there’s a contract rate—they pay it, I pay the deductible and co-insurance if applicable, and that’s it. Not with this outfit. They keep telling me they’ll defend this on my behalf at no cost. How naive do they think I am? They are just administrators trying to save my employer money at my expense. This is terrible insurance. The absurd part is the hospital offering a payment plan of $8,000 per month!