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I am a little :-; behind in reading my mail, and just came across your posting. I work in a hospital and deal with contracts between my hospital and insurers where discounts are involved. My experience is that the contract language between the hospital and the insurer forbids the hospital to bill the patient for anything other than copays, deductibles and non-covered services. In other words, the hospital contractually agrees that it will not bill the patient for the discount. I am surprised that Aetna would not assist with the billing problem. Perhaps a call to the state insurance commissioner's office would help .......