I have a PPO plan, yet for yet they have refused full payment a a secondary insurer. I was of the impression
1) that as a PPO member you have the right to go to anyone.But that everyone may not accept it and you need not permission first
2) that for mental health it was a requirement that any insurer whether a PPO or HMO has to accept the full insurance charge, and if not they should inform the client that this is not allowed.
I have had to pay over 140 dollars. That I have had to pay. I do not know whether deductible applies.
Second complaint they refuse to pay or add the amount to deductible to nearly every office charge. Ihave kept on hearing from them that that is the policy we chose. I have had nearly 5000 dollars in charges that they have credited only 2100 credited to my deductible it would be cheaper for me to pay off the deductible than wait to reach it through the usual process. I had a 31000 bill from Stand for which they have only given me $600 towards my deductible.