What are the typical differences between a reasonable and customary charge and the non network hospital pay?

What are the typical differences between a reasonable and customary charge and the non network hospital pay?
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#1

My son has had a psychotic break and is in patient at the best hospital in the area.

My insurance says it pays 100% after a $3000 max is payed for a out of network hospital stay. I found out today that 100% is only what they would pay. Since they do not have an agreement with the hospital, we have to pay whatever the hospital charges minus what the reasonable and customary charges the insurance pays.

The hospital cost is $2190 per day (no doctors or medicine).
The insurance company will not say what they will pay per day. How can that be?
How much is typical for an in network hospital? (Atlanta area)
How bad will it be per day?
Thanks!
Concerned Dad


#2

Why not have the hospital call and verify insurance coverage for you. The hospital should be able to provide you with a cost estimate.
You might even want to look into financial assistance after insurance has processed the bill.
Best of luck to you.


#3

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