Question:
Is this a usual practice?

Is it customary for a Dr. or Surgeon to charge more than the insurance company pays and then pass the difference in cost on to the patient?    — LM O. (posted on September 11, 2002)

September 11, 2002
No, not if you are in an HMO or a PPO or other group type of incurance. In fact, it is illegal in many states to do that. Talk to you insurance compnies customer service to find out if it is OK for your plan.
   — Vicki L.

September 11, 2002
You should receive an EOB (explanation of benefits) from your insurance company and on there it will tell you what your responsibility is to pay. Yes there are instances where you will have ot pay the difference. It all depends on the contract that the doctor has or does not have with an insurance company. It also depends on your own policy and the type of coverage you have. You can also talk with your doctor and see if he will accept what the insurance company pays or see if he will accept payments.
   — Sue A.

September 11, 2002
Doctors ALWAYS bill more than the insurance will pay. Insurance companies calculate their benefits off what is called reasonable and customary charges. Whether you are responsible for the difference is up to your coverage and if you went to a participating surgeon. If the surgeon is contraced with your insurance company he is to write off the difference between the reasonable and customary charges and his billed amount. You would not be responsible for that. IF he is not contracted, YOU are responsible for the difference.
   — RebeccaP