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I don't think they should be even able to bill if the insurance does not accept the charge. They should have to work it through insurance first and if insurance denies it they can get a signature of the patient to say they will pay but the form they sign must show the response from the insurance company to show they went through the process and determined it cannot be done with insurance. It can't be some sort of standard form every patient is required to sign before even being seen.
This. I had to get an MRI done to diagnose severe stenosis in my neck. I had to wait 3 excruciating months for the appointment, I had lost almost all ability to care for myself, couldn't walk, couldn't use my left hand due to the muscle spasms. I go to the hospital the day of my appointment, the desk clerk says
"sign this for that says you'll agree to pay if insurance denies the procedure"
"Ok, I have insurance and (in hindsight) I'm going to die if I don't get emergency surgery soon, insurance should cover that right (signs)?"
"Sure"
2 months later...
Hospital "Insurance denied your claim because we didn't bother to submit a pre-auth, you owe us $6500."
"Ok I can't pay that, can I pay a little while I try to work with insurance"
"Sure, go ahead and agree to this 60 month payment plan, it's only $100/mo"
"Ok, I'll do that for now while I try to negotiate with everyone"
Bank that now owns my debt and cannot be negotiated with: "No negotiations, we own $6500 in debt, we want $6500"
Even if they submit the pre-auth I have had so many denials that show up a month after the procedure was done and for things were it could have waited. It had to be done and maybe its way worse to wait but this is america so it can wait (not yours but things from my family). I can budget for maximum out of pocket each year but not for maximum out of pocket and someone unknown amounts that has no upper ceiling. and to get off topic I love the we won't cover this pretty cheap and easy thing that has been around for awhile and has a proven track record to work or improve outcomes but we will this big expensive surgery that you know oftentimes work but if it doesn't, woa baby your quality of life is sunk. but hey your choice. its like a game of chicken. their cost versus your willingness to risk aweful outcomes.