It's not very clear what the bill actually says. Can you share it here? Or just DM me. Just black out all the personally identifiable information, provider info, etc... It would just help to see the breakdown.
Additionally, post the EOB (Explaination of Benefits) your insurance should have sent you when they processed this claim. This should also available on their website. If the amounts the EOB say you owe and the provider bill aren't the same, don't pay the bill until you understand the discrepancies or the bill is fixed. If the insurance has not sent you an EOB for the claim yet, don't pay the bill yet.
Here's some info on medical billing that might be helpful to you.
With medical billing. You should see a few things.
First is the amount the provider charged. This is fictional made-up price that literally nobody pays. As a provider, your doctor agreed to pre-negotiated rates with your insurance. So if they say charged $500, the rate with your insurance should be less. For arguments sake, let's say the charge gets adjusted to $135. Then based off that $135 adjusted rate, you will owe your insurance's cost sharing amount. (aka, deductible, co-pay or co-insurance) however it's outlined in your insurance contract.
Your insurance though will only have per-negoitated rates for charges that are covered. If it's not covered, you can appeal if you think the insurance made a mistake.
Patient Financial Responsibility Liability. How you can protect yourself against fraudulent billing
If a charge is not covered, the provider will try to privately bill you for the non-adjusted charge. Whether they have the grounds to collect on you depends if you were foolish enough to sign a personal financial liability clause/form when you filled out the patient paperwork. That form gives the provider permission to privately bill you for charges, regardless of insurance coverage etc... This is optional and you should never sign it if you have insurance the provider is in-network. You are effectively signing away your insurance protections. You can still try to argue with the provider and complain that you didn't know what you were signing, but this will be on you. Read things before you sign things.
In the future, never sign it. Cross it out. I often write "provider agrees to only perform service covered by blah blah blah insurance. Patient is not responsible for non-covered services without written permission from patient." Something along those lines. I also take a picture of the form which I have used to fight fraudulent bills. Going along those lines, never give out your social security number. Apart from actual health information, your insurance information, permission to bill your insurance, and basic contact info, they do not need anything else, so don't offer it, even if asked.
**If an in-network provider refuses to see you because you refuse to sign the form (very uncommon), you can try explaining to them. Even the front-desk and billing specialist can be ignorant. Very rarely, they know exactly what they're doing and don't budge. This is an obvious red flag. Leave the office and report them to the insurance company. Refusing to see you because you refuse to sign away the insurance protections violates their contract. You can even file a formal report with your state against the provider and the insurance company if nothing happens.
Balance Billing
I talked about bills that have charges that aren't covered. Balance billing is different. Going back to the example of them charging you $500 and the adjusted rate which for arguments sake I said could be $135. The provider will only receive $135 for the charge, either from you, your insurance, or you'll share the cost. They won't get the $500 they wanted. Balance billing is when they try to collect the full $500, so they'll charge you for the difference of $500 - $135. This is considered a predatory bill and diminishes the value an insurance policy gives you. - Some insurance companies have balance billing protection - Some states have balance billing protection, but only on some plans. On 1/1/2022, all the rest of the states will adopt similar guidelines. - Until January next year, if neither your insurance nor state have balance billing protections, you're going to be shit out of luck. You'll have to work something out with the provider.
There's other billing issues and thing, but these tend to be the more common issues. There's also surpise bills which occur when you go to an in-network provider like a hospital and get a bill from an out-of-network doctor that billed privately from the hospital. New regulation is on your side with this one at least, but you need to be careful. With predatory billing and improper billing, it is on you to get what you need. If a provider ever sells their debt to a collection agency on a bill that was not billed properly, do not talk to or recognize the debt with the collection agency. Contact the provider or contact your insurance. Get the provider to clear things up with the collection agency. The most communication I would ever have with a collections agency is sending a cease and desist letter and informing them of the illegitimate debt. Otherwise, I just monitor my credit and let them waste money on postage.
You should also monitor your credit and watch out for these. I literally just recently had to deal with a collection agency for a bill that I never received. The provider sold the debt to a collection agency without ever trying to bill me. The provider's office lied and said I never gave them my address. I have photos of my patient forms, (remember I said to take pictures of those forms :) ). I very politely, (very angry lol) told them to contact the collections agency immediately to inform them of the illegitimate debt, I'd send a complaint to my insurance, and I would report them to the state for fraud. They luckily never went after my credit, but I would have definitely sued them if they did. A lot of billing offices deal with people that just don't want to pay their legitimate bill. A lot of them just don't bother trying to collect and just sell the debt off because it's easier which is illegal.
Another lesson. Always question the bills and who you're getting them from.