Say you get some PPO insurance with a 1k deductible that doesn’t cover office visits. You go to the doctor in the PPO and get diagnosed and treated for $200. Would you have to fill out paperwork to tell the insurance company you have spent $200 of your $1000 deductible or would they do that automatically for you or does it vary based on insurer.
It usually varies based on the doctor. Some will submit your claims for you and then if there’s a balance, they will bill you. So in your case, if the doctor billed the insurance company, the company would see that you still need to use up the deductible and they would inform the doctor that your claim is denied since you haven’t reached the deductible limit yet. Then the doctor’s office would bill you for the $200.00.
Other doctors want payment up front: you pay them and then you submit the claim yourself and the insurance company reimburses you directly. If you aren’t due a reimbursement because you haven’t fulfilled the deductible yet, they at least know that you have paid $200 of it.
If the doctor wants payment up front, they do not, in my experience, notify your insurance company that you have paid a certain amount so far to them - that’s your responsibility.