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RE: Anyone ever had a "Sports Hernia" aka: "Sportsman's hernia", "Gilmore's groin", or &
I had my surgery less than 3 weeks ago, and got my "explanation of benefits" on Friday for a few things. I'm still a little uncertain even what it means. The EoB has two things from my MRI, and one from the anesthesiologist. Everything is under the column "not payable by plan."
One of the MRI things and the anesthesia had these two codes on it:
1 - Your plan does not provide coverage for charges that you are not legally responsible to pay.
2 - THESE PROFESSIONAL CHARGES ARE INCLUDED IN THE NEGOTIATED RATE FOR THE RELATED HOSPITAL CONFINEMENT
And the other MRI thing had this code:
3 - This service was not precertified and the provider may not bill you for this service. The provider may bill you if agreed upon prior to the performance of the service.
I recieved a bill for $431 for one of the MRI charges (the one with codes 1 and 2) a couple weeks ago. I payed it with my credit card, but when I got my credit card statement, it was credited back.
So, I really don't know what's going on.
By the way, do you have HMO or PPO?
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