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    pastor1189's Avatar
    pastor1189 Posts: 1,538, Reputation: 3
    Ultra Member
     
    #1

    Jun 2, 2017, 03:14 PM
    Medicare HMO Humana
    How does that work? Neighbor had Medicare Humana HMO.
    She paid her co-payments. What the dentist ask for and what he got.
    Was discounted greatly less by Humana. I saw this procedure before. But my doctor never said anything to me about the shortfall
    Do you think the dentist will try to get his remaining balance from the patient?
    ma0641's Avatar
    ma0641 Posts: 15,675, Reputation: 1012
    Uber Member
     
    #2

    Jun 3, 2017, 05:56 AM
    No, you pay the copay. Humana has a pay scale and the dentist agreed. This is a Medicare Advantage Plan?
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
    Computer Expert and Renaissance Man
     
    #3

    Jun 3, 2017, 06:31 AM
    The way most network plans (like HMOs and Medicare) work is that the member providers agree to a pay scale set by the network. They do this because patients are then steered to member providers. So that's why you see the amount the providers charges non member patients and the amount the plan pays. The provider then sort of eats the difference. In reality the provider costs are usually way inflated and they don't really expect to receive that amount.
    pastor1189's Avatar
    pastor1189 Posts: 1,538, Reputation: 3
    Ultra Member
     
    #4

    Jun 3, 2017, 07:07 AM
    Yes that what I suspected

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