Insurer tries to get away with: the provider is not in network, but not strictly out of network (because they know that would be covered by the law), so they call them "participating", a 50% coinsurance applies and patient owes 121K.
(Resolved in patient's favor after state government got involved and media coverage about it).
Insurer tries to get away with: the provider is not in network, but not strictly out of network (because they know that would be covered by the law), so they call them "participating", a 50% coinsurance applies and patient owes 121K.
(Resolved in patient's favor after state government got involved and media coverage about it).