Contesting a Doctor's Billing (pains, blood tests, arms, insurance)

[britanylynn]

Hello Everybody,

I am in need of some advice about my doctor's office billing me for blood tests. I will give you all of the details.

So I went to the doctor for a check up because I had been having some side pains due to my diet. When I checked in, the nurse stated that my insurance was active and charged my the usual $20 co-pay. My insurance cover's blood tests. So they gave me a check up and the doctor and I agreed to do a blood test to check my vitamin levels because my family is known for an iron deficiency.

A week later while waiting for my blood tests to come back, I found out I was dropped from my father's insurance plan. The office stated that I had to come in the find out my results and that I would have to pay for a full price appointment without insurance. I didn't have the money, so I didn't go back or find out my results.

A month or two later I received a bill from a collections agency saying that I owe almost $700 for the blood work I had gotten done. I now know I was dropped from the insurance prior to the initial doctor's appointment. Which would I have known that, I would not had gotten the blood work done at all. Now, I tried to get a hold of the doctor's office and I have found out that they are a part of a larger company, but that location has shut down. Now the bill is on my credit report and I am not sure what could be done, or if I have to pay it off.

Any information would be greatly appreciated. Thank you all for reading.

[azriverfan.]

The doctor's office has no responsibility in this. This is between you and your insurance company. It is your responsibility to verify your policy with your insurance company prior to seeing the doctor or getting anything done including labs. At this point, you should communicate with the lab directly and negotiate a lower fee and get placed on a payment program. It seems somewhat surprising because the lab is also supposed to verify your insurance prior to drawing anything. At least in Arizona, Sonora Quest is good about verifying insurance status prior to a blood draw.

This is a good lesson for everyone. Always call your insurance company ahead of time to verify a procedure and what your out-of-pocket expense would be. In my experience, there have been occasions where a hospital or physician's office will say something is not covered when in fact it is covered. Or a hospital may ask for money upfront prior to discharge. I would wait until the insurance company processes that and have them send you a bill before paying a hospital up-front money. During one occasion, we had met our deductible but the hospital didn't take that into account. So we paid the hospital a fee that we didn't owe. It took us a year to get that money back from the hospital after contacting our insurance company. What was sad is the hospital's finance department had the check waiting in their system for us but never mailed it out. It wasn't until we called that they sent it out. What we should have done is told the hospital that we had no deductible and would wait for the insurance company to bill us. That happened to us on two occasions.

[imagineAA]

Totally true.^

An insurance policy is a contract between you and the insurance company. Your healthcare provider is doing you a courtesy of accepting payment directly from your insurance company, but that's it.

[SmurfOnABoat]

Well, you have a few options.

First, you pay the bill, which is technically your responsibility since you made the assumption that you had active insurance and did not.

Second, call the doctors office billing department (located on your bill) and tell them the scenario and circumstances with the insurance being canceled and ask them if they can help in any way, since their office staff did not verify insurance prior to procedure. It is essential that every physician practice verify the insurance eligibility and benefits of patients before services are provided, that is their fault. The office might have different billing plans for uninsured individuals, such as a CAP program. They might be able to offer this to you and re-bill you accordingly.

It really is a bad situation and it will indeed affect your credit negatively if it goes unpaid. So I would contact the physician (staff) and see what can be done, if they can lessen the bill and/or set up a payment plan for you.

Last option would be to apply for care credit (if that office accepts it) and use it to pay the bill that is outstanding.

Best of luck to you! Hopefully you get the matter settled with minimal damage to your credit and wallet.

[ji603]

So notwithstanding the fact that you did receive service from the doc, or that perhaps that really does cost $700.00, but you have a few other options too.

You could send a simple letter to the collections agency saying, "i dispute this debt, please validate it" and see if they provide proof that you owe it- or you could just ignore it. Medical debt is not the big FICO killer it once was, and you could forget it perhaps until they call you to settle, or you get served and have to show up in court to avoid a default judgment. Maybe you get lucky and nothing happens for 7 years, and the account falls off your credit report.

Checkout creditboards.com for a little help, and good luck.

[MN-Born-n-Raised]

Originally Posted by britanylynn

Hello Everybody,

I am in need of some advice about my doctor's office billing me for blood tests. I will give you all of the details.

So I went to the doctor for a check up because I had been having some side pains due to my diet. When I checked in, the nurse stated that my insurance was active and charged my the usual $20 co-pay. My insurance cover's blood tests. So they gave me a check up and the doctor and I agreed to do a blood test to check my vitamin levels because my family is known for an iron deficiency.

A week later while waiting for my blood tests to come back, I found out I was dropped from my father's insurance plan. The office stated that I had to come in the find out my results and that I would have to pay for a full price appointment without insurance. I didn't have the money, so I didn't go back or find out my results.

A month or two later I received a bill from a collections agency saying that I owe almost $700 for the blood work I had gotten done. I now know I was dropped from the insurance prior to the initial doctor's appointment. Which would I have known that, I would not had gotten the blood work done at all. Now, I tried to get a hold of the doctor's office and I have found out that they are a part of a larger company, but that location has shut down. Now the bill is on my credit report and I am not sure what could be done, or if I have to pay it off.

Any information would be greatly appreciated. Thank you all for reading.

For starters, $700 (retail) to check iron is highway robbery. Further proof that the medical system is chronically broken. I'd call the clinic billing department directly (NOT anybody that they subcontract for collections) and ask them what the insurance rate is for the bloodwork. I'm guessing $150 for the appointment and $150 for the bloodwork. Offer to pay that in person after you get the results. If they say no, then walk. Explain that retail is out of the question and you will never ever pay that amount. You have NO legal leg to stand on but the doctor's office should be rational because they have two options. Get the same money as before (by you paying versus the insurance company) or nothing. I'd set the stage in that fashion and deal with strength.

With this all said, sleep like a baby. Over the years, I've had to negotiate with clinics, ER, and other extortion that were overcoded. Even if they are irrational and say no, I predict your credit score is going to be just fine (assuming they bother with reporting it).

[britanylynn]

Thank you all very much for the responses. I will definitely try to negotiate at least a lower price with Lab Corp considering that is where the tests were sent to, and the bill is from. I will also contact the doctor's billing department and let them know what I am doing. I will call today and when I find an answer, I will post the outcome.

[fiberpills]

Heck, just be honest and tell them what happened. You aren't the first person who has had this happen to them.

The $700 is basically the inflated charge to cover the fact that not everybody who gets a blood test can actually afford it (plus all the overhead of insurance, etc..)

[britanylynn]

So I definitely called the Lab Corp office rather than the collections agency. The collections agency was not able to lower the balance but when I called Lab Corp and explained the situation, they reduced the balance by about $200 which is better than nothing. I did have to pay it all at once.

[MN-Born-n-Raised]

Originally Posted by britanylynn

So I definitely called the Lab Corp office rather than the collections agency. The collections agency was not able to lower the balance but when I called Lab Corp and explained the situation, they reduced the balance by about $200 which is better than nothing. I did have to pay it all at once.

Note: the collection agency is different that the collection department in the clinic. Collection Agencies will give ZERO to the doctors office. The collection agency buys bad debt at pennies on the dollar and strong arms people into paying. I'd personally never pay a collection agency. I've had situations where I refused to pay for substandard service and they sent it to collections. They go aways eventually. Don't expect your credit rating to take a hit.

I do love to pay my bills. But a couple of times I got terribly service at a doctor's office and (zero follow-up etc) and I refused to pay (I told them why). Your situation it is different. You kind of got the services (without the results). Explain your rational point of view (you mandate the same insurance rate and you need the results or you pay ZERO). Be nice, tell them this is your last try and see what they say.