Another anecdote to this point: I had an experience in which a doctor accepted me as a patient (knowing what insurance I had and what reimbursement rates the insurer would pay), performed a procedure for me, then subsequently found out my insurance would not cover the procedure (because of a preexisting condition waiver I did not know was still in force).
The doctor then demanded full payment for his non-discounted rate-- 6x the insurance reimbursement rate.
To my mind, acceptance of the "deal" was done when the doctor took me on as a patient and agreed to perform the procedure. At that time the practice had full knowledge of what the reimbursement rate would be. I see the doctor's "windfall" of demanding the non-discounted rate as being fraudulent.
I met with the doctor face-to-face. He felt that he needed to stand-by his policy of demanding the non-discounted fee. He did not believe the rate for the service was set when he accepted my insurance (with a known reimbursement rate), but rather was based on his billing staff finding the highest amount to bill after the procedure was complete.
He made an argument (that I considered specious) about "fairness" to other patients and problems he'd had in the past with patients mistreating the office staff because of perceived "unfairness" in his offering discounts.
My attorney advised me that I'd likely spend more money fighting the doctor than just paying him. Because I care (probably more deeply than I should) about my credit rating I opted to pay the doctor and put the whole mess behind me. I also ditched my pre-ACA insurance that carried this never-expiring pre-existing condition waiver and moved to an ACA plan with no such waivers.
The surgery center that was involved in the ordeal was much more reasonable, BTW. They charged me the amount my insurance company would have reimbursed them. When I brought this up to the doctor (who is also a partner in the surgery center business) he simply stated that his office's policies differed from those of the surgery center, and that his policy was to receive his full fee.
The doctor then demanded full payment for his non-discounted rate-- 6x the insurance reimbursement rate.
To my mind, acceptance of the "deal" was done when the doctor took me on as a patient and agreed to perform the procedure. At that time the practice had full knowledge of what the reimbursement rate would be. I see the doctor's "windfall" of demanding the non-discounted rate as being fraudulent.