Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
If the doctor's office made an error and checked the wrong box on the lab form, they should be willing to contact your insurance company and the lab about their error and make it right. If the lab ran the wrong test then they should write off the charges. Either way, if it was an error and you are calm, polite and knowledgeable, I bet you will find someone willing to help you out.
It may not be that your physician ordered the "wrong" tests, but may have coded them wrong. Every blood test or x-ray order, must be attached to a billing code (ICD 9 code) that links the order with a problem or reason it is being ordered. An ICD 9 code may be an actual diagnosis such as hypertension or a symptom such as vomiting. Call the insurance company, ask why it is being denied, then contact the ordering physician.
Let me clarify.
I regularly go to a lab to get my cholesterol checked and there has never been a problem. On my last visit they said they are able to do blood tests in house now. I thought that was great and the discussion went into how they are now able to check cholesterol etc. There was no discussion of them sending anything "Out" because they said they can check cholesterol in-house. So checking things like Vitamin D and a bunch of other "Coded" tests that I have never had done before were never part of the discussion.
Its like brining your car to the oil change place and them charging you for battery acid tests and other things that were never discussed.
I never signed anything, I am a regular patient.
So, now they are going to re-code things to get this covered under my insurance company. Will this mean 5 years down the road I wont be able to get coverage because I find out my doctor filed some code that says I got some rare disease in order to get a test paid under insurance?
I didn't authorize it, I wasn't informed about it.
My "Policy" is that I do not pay for something I didn't order. Maybe their policy is different.
Going to visit the doctor office today to dispute.
If they never discussed the labs with you, you should not have to pay for them. You could give them a reasonable chance to try to get the labs paid for by the insurance, but only if they are able to explain to you how these labs were necessary for your care.
When doctor's offices have in-house labs, pharmacies... they do tend to be more aggressive about using those services. Though they don't need your consent for every lab test (I'm sure you signed some sort of a global consent), it is the standard of care to explain to a patient what tests are to be done and why they are being done. If they don't have documentation in their notes of that conversation, then the conversation did not happen and they should reverse the charges.
Better to work with the doctor if possible to get it worked out. Personally, I trust my doctor unless there's an obvious reason to not trust him. When the insurance had a problem with a certain lab one time, it was handled and worked out eventually.
at this stage you can ask an explanation to the doctor.....tell the doctor those tests are unnecessary for me...you have full rights to ask for a justified answer....you can take strict action against this....
Great, now here it the EOB for my visit. After my co-pay I am now responsible for another $325.
So AFTER insurance (That I pay $800 per month) It cost me $800 for a physical?
THis is crazy!!
Anyone know a good attorney in the Raleigh area?
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
