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[IP] Balance Billing for Pumps

Dear Group:

I wanted to throw this out for some feedback. I understand that some
persons have been "balance billed" directly by the pump companies for
the difference between what their insurance company pays for the pump
and the full price of the pump. For example, health insurance company
"X" pays a contractual price with pump company "Y" for $3,200 for your
pump. Obviously, a discounted price to entice your insurance company to
use their product. However, then the pump company attempts to directly
bill the patient for the  difference between that discounted price and
the full price of the pump (say, around $1,800 in this case). I
understand that this is not legal, but it has been reported to me as
being a fairly common occurence. If you don't review the EOB
(explanation of benefits) on your health insurance policy, many may
actually pay this difference when they are not supposed to do so, or
should challenge it. My question is: how many have had this happen to
them and if so, how did you deal with it?


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