Hello r/healthcare,
I recently went in to a new GP for a routine exam/blood work. While there, my doctor was asking my medical history and I told him that years ago I had been diagnosed with Mitral Valve Prolapse and that I had not had my valve checked since then. He recommended that I have an EKG done just to make sure everything was going ok, and I agreed. I asked him if my insurance would cover it, and he said that since I had been previously diagnosed it would. I went in to get my EKG done, all was normal, then I received a statement a month later saying that my insurance had been billed $6,800 and my remaining balance is almost $1,000 due to coinsurance/deductible.
A couple of issues here - I live in a state that has surprise billing protections. I had asked beforehand if my insurance would cover the EKG and due to the verbal confirmation I received, I made a decision to have the EKG done. Would this fall under surprise billing?
Second question - is nearly $7000 for a routine EKG normal? Just by googling I see that the average cost is $1500 in the US and I find it extremely odd that my insurance was billed almost 5x’s the national average.
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