I recently told the receptionist at my doctor’s office that I wanted to pay cash for my appointment instead of using my insurance because my deductible is really high. But she told me that would be considered fraud, and I’m honestly confused.
I mean, if I pay cash for a fender bender instead of going through my auto insurance, no one bats an eye. Is it different when it comes to medical insurance? If so, why is that?
I’m trying to understand how this could be fraud when I’m just trying to save some money. Any insights would be appreciated…Thanks
A lot of provider contracts with insurance companies prohibit providers from letting patients who are known to have insurance pay cash. In certain states, this is being contested as lawful.
It is the provider’s business discretion to decline your request if they are unable to comply. In essence, you would have to find a new physician and hide your insurance from them.
If the provider is in network with your insurer, they would be in breach of their contractual terms, even if the word fraud may not be quite appropriate.