A TikToker was shocked when she received an unexpectedly high bill for a procedure that her Blue Cross Blue Shield insurance was supposed to cover. But thanks to some sleuthing, she found a hack to ensure she paid what her doctor’s office originally estimated.
KySlavens (@KySlavens) shared her experience in a video, asking her audience if she was justified in her frustration after receiving an estimate for a procedure that turned out to be very wrong and being left responsible for the full bill.
Uploaded last week, the video has since racked up over 590,000 views.
“I need someone to tell me that I’m wrong,” KySlavens began.
Here’s what went sideways.
The estimate
With a screenshot of the procedure estimate displayed behind her, KySlavens recounted what happened.
“I called our provider to ask how much a procedure would be with our insurance so we could decide if we were going to do it or not. They gave us an estimate. You can see it says $40. It says, ‘Your insurance will cover this. They have our insurance details,’” she explained.
She pointed to the estimate showing a $1,151 cost, with insurance covering $1,101 and a $40 copay.
“So we said ‘Oh, are you sure? It’s only going to be $40?’ and [they] said ‘Yeah, you only have to pay [the] copay,” she added.
When KySlavens received the bill after the procedure, the amount on the bill shocked her.
“Insurance didn’t cover a single penny. They charged us the full $1,000, and I just feel like that’s wrong,” she said.
KySlavens felt frustrated. The disclaimer did state that the estimate wasn’t guaranteed. However, she remained upset because the procedure estimate turned out to be so wrong.
“It sucks, and listen, I realize it says it’s not a guarantee—it’s based on the information they currently have. But they clearly have our current information, so why would I ever think that they would be over a thousand dollars off?” she questioned.
Viewer consensus is clear
Commenters filled the comment section, advising others to always check with the insurance company to verify coverage.
Someone warned, “Your doctor’s office does not know the details of your plan. Please, please, please always call your insurance first.”
“I work in medical billing answering phones. I deal with your situation all day. And while I agree it’s messed up I always tell people to call their insurance and what we tell them is an estimate,” another comment read.
One commenter suggested contacting the insurance company for clarification, asking, “Did you try to call your insurance company and see if they’ll give you an explanation? [I almost] wonder if they billed it wrong?” To that, KySlavens responded in a brief TikTok.
“I did call them and they told me that they don’t know why my provider would have ever told me that because they do not cover it, would not cover it, and have never covered it, and pretty much just said good luck,” she said.
How to get a procedure estimate that’s accurate
The comment section also included suggestions on using CPT codes to verify insurance coverage for a procedure.
Healthcare professionals use CPT codes, or Current Procedural Terminology, as a standardized medical code to identify and describe medical services and procedures. Maintained and published by the American Medical Association (AMA), CPT codes “provide a uniform nomenclature for coding medical procedures and services” across the healthcare field.
“If you’re wondering whether the services you need will be covered, you can call your insurance company, provide the CPT code, and ask if it will be covered,” one comment suggested.
The commenter elaborated, saying, “Using the CPT code helps eliminate confusion when speaking with insurance representatives—sometimes they may not be familiar with the specific service you’re inquiring about. By providing the CPT code, they can easily input it into their system to give you a definitive answer about coverage.”
The final bill was only $40 after all
In a follow-up video, KySlavens shared that she contacted the doctor’s office, and they offered a partial “administrative write-off.” She was now responsible for only a portion of the original bill.
However, less than a day later, KySlavens uploaded a final update. She went back to the provider and requested a recording of the call where she received the wrong procedure estimate. After reviewing the recording, they decided to “write off” the entire amount based on the call’s information.
The original $40 copay was all she was responsible for.
The video concluded with a word of caution: “If you’re ever having anything done, my God, call your insurance first.”
KySlavens did not immediately respond to the Daily Dot’s request for comment via TikTok Direct Message.
@kyslavens Will be calling insurance directly from here on out. #greenscreen #insurance #healthcare ♬ original sound – KySlavens
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The post ‘You sure?’: Woman’s Blue Cross Blue Shield bill $1,000 higher than she thought. Here’s the trick she used to only pay $40 appeared first on The Daily Dot.
