The doctor charged $3,500.00 for a medical procedure and insurance company only paid $2,000.00 because they say this is the UCR amount. Can they do this and do I owe the difference?
Unfortunately, the answer is yes. Medical fees do not always follow “rational” patterns and medical providers are free to charge according to their own fee schedule. To ensure rate stability and uniformity of coverage, UCR fees are established and serve as the maximum allowable charge for all insureds.
