If our insurance reaches its max payout during a procedure, can the provider come after us for the billed amount or are they limited to amount allowed?

If our insurance reaches its max payout during a procedure, can the provider come after us for the billed amount or are they limited to amount allowed?

My wife had Surgery on her ACL and Meniscus. It was an in-network provider. The billed amount was $32,000. The amount allowed was $8,200 and our insurance reached its maximum annual payout and will only pay $3,000. Can the provider come after us for the billed amount or do they have to stick to the amount allowed on the EOB?

Asked on March 24, 2012 under Insurance Law, Michigan

Answers:

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