My ex-t and I had an arrangement where she gave me a super bill and I'd submit to my insurance company and they'd reimburse me and I'd remit the payment to her.
She said she would accept whatever the insurance paid out, which looked to be 70% of the normal rate for out-of-network providers.
The first six sessions were billed and because I have a HRA, she rec'd her entire fee for each of those sessions ($125). My insurance hired a third party benefits administrator, so reimbursements are taking longer than usual to come in. I still send payments to her when I receive them.
Today, I just rec'd notification from my insurance that they are no longer going by the INDIVIDUAL deductible, but by the FAMILY deductible (apparently, they only keep the individual deductible amount on their site, for looks, I guess). This means that because of this change, I'll owe about $1200 more out of pocket than I had anticipated (the FAMILY deductible is twice the INDIVIDUAL amount).
So, I have to pay out of pocket. My ex-t said she would accept the 70% rate that my insurance pays when my HRA is extinguished. Well, I've tapped the HRA out and now have to pay this myself, whereas she and I both thought that the insurance would be paying it...I hadn't anticipated this change, resulting in the deductible not being met.
I really don't want to contact her and dredge all that up again, as I'm in "no contact" right now, simply because of how much it hurts.
What would you do? Would you send her the 70% out of pocket or remit the entire portion that she billed?
I feel like I SHOULD send her the entire amount, even though she agreed to the 70% (via my insurance), but I'm unsure as to why. I feel like I want to apologize to her for only send the 70% in, even though it's the same dang thing my insurance would have paid out.
Last edited by Calilady; Aug 10, 2017 at 10:35 PM.
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