Negotiated Fee Rate is the amount of payment that an Insurance Company has negotiated with the Participating Provider as the maximum they can charge 

Excerpt from Blue Shield Explanation
Excerpt from Blue Shield Explanation

It’s the  secret number the insurance company and the provider have worked into their contract. The industry often calls that number the “adjusted rate” or the “negotiated rate.”

View an actual Specimen Policy Explanation – Page 42 Blue Cross EOC  & 167

More explanation– Can MD’s charge more? Uninsured?

How do I know that the amount you are billing me is the correct amount?

Once your insurance carrier pays their portion of the bill, they will send you an explanation of benefits (EOB) to show how the claim was paid. You can compare your EOB to the statement sent by the hospital. How the carrier paid the claim is based on their contract with us and their contract with you. If you feel the insurance company should have paid a higher amount, please contact them directly for resolution.   Learn More ===> Patient Billing FAQ’s

True Cost of Health

Todd Friedman, Esq. can help if debt collectors are harassing you when you don’t owe the $$$

Might it be better to pay cash? 

LA Times 6.10.2016


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