My Insurance Company sends me a report every month.
They list each line item and what the doctor/hospital Charges Everyone.
Then, the line item lists the Contracted amount, that is the Insurance Company's Responsibility.
Then, the line item lists the amount, that the insurance company will Not pay and notes this amount as the Provider's Responsibility.
Then, the line item lists my copay amount or lists the co-insurance amount as the Patient's Responsibility.
Every month, I am still amazed at what the doctor/hospital charges and the much smaller insurance contracted amount.
How do the doctors/hospitals get away with charging uninsured patients the Full Amounts when they are very willing to take much less when a patient has insurance and the doctor/hospital has contracted with that insurance company for much less?
Sorry, I digress.
Without the actual document in question:
We do not know if the $14,000 is Before or After the insurance paid their contracted amount.
We do not know if the Deductible has been applied.
We do not know if the Out of Pocket Maximum has been applied.
IMO, the charges are just that. Charges.
The full charged amount Before any contracted rate, deductible, or out of pocket maximum has been applied.
IMO, the Actual payment amount is much lower than $14,000.
IMO, NP is blowing it up bigger than it really is because $14,000 sounds so unimaginable when in fact the Pay Amount is much lower.
MOO