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Old Dec 21, 2016, 11:31 PM
Pennster Pennster is offline
Poohbah
 
Member Since: Aug 2013
Location: US
Posts: 1,030
Thanks for that, skies - I guess we just need to know whether it's in-network or out of it. Wheeler can clarify if this is in-network or out-of-network, but I think the op's use of the word copay implies it's in-network.

The in-network doctor doesn't usually get to do balance billing, as the insurance company has negotiated a different rate. (I don't want to overgeneralise as maybe it's different in different states? But it is my understanding that it can be a violation of the in-network doctor's contract with the insurance company to charge more (or less, for that matter) than the insurance company says the client is responsible for.