Cost of Cystic Fibrosis Test

skatergrl

At my 15 week appointment, I turned down all genetic testing. My doctor said that was fine but I might as well do the Cystic Fibrosis test since it was only 20 some dollars. I figured for the peace of mind, that was worth it and did it (thankfully it was negative). As ridiculous as this now sounds to me, I thought he was saying the cost of the test itself was 20 some dollars (FTM). I just got the statement from my insurance company this weekend. The test was $1,611 and I am responsible for $644!!!

This morning I left a message with the billing person at the office explaining what he had told me it would cost and what my statement is now saying. Looking back, I'm realizing he was probably guessing what my co-payment was and not giving me the cost of the test itself which of course, he shouldn't have done without having someone check to be sure. I haven't heard back from the billing person yet so I may still have some hope there. However, I called my insurance company today and they said it was because the lab the test was sent to was out of network. Ugh. I should have taken it upon myself to find out what my cost would be and have certainly learned a lesson. 

I'm actually seeing this same doctor on Friday. If I don't get any help from the billing person (I'm sure there's nothing she can do) do I mention this to the doctor as an "in the future, please don't tell someone it will cost X unless you've checked their insurance?" My husband thinks we should but I'd really like to not piss off our OB.

jess412love

Yeah the same thing happened to me and my husband, quest labs (who processed the blood tests) wasn't a covered provider under our insurance. It was our fault for not checking and just assuming we were covered. We ended up having to pay almost $2,000. It sucks I know. But after its all said and done your ob isn't responsible.

skatergrl

Thanks ladies. I won't mention it to him. It was definitely my fault for not checking. Just frustrating. I went in there and checked "no" next to each genetic testing box and the only reason we scratched it out and did it was because of the low price he told me. But I shouldn't have assumed that was the cost of the test (and now seeing how expensive the test was I'm really embarrassed to admit I thought the test was that amount) and should have asked and then checked my coverage. Ugh, lesson learned. Yes, it does go toward my deductible but we have a higher deductible and most of the pregnancy stuff isn't applicable toward our deductible so we aren't going to meet it this year - even with this. But thank you all for your input.

bdazzld

I did the CF test as well and since I'm HMO in THEORY it should have been covered but my benefits site is saying I'm responsible for 200$ of it...but I haven't received a bill yet.  My husband also had the test since I am a carrier, so we could potentially owe 400$ total I'm sorry! I would try to argue it down if possible through the billing group.

skatergrl

Thank you! I'm going to try that to see. It's worth a shot! I guess I'm no worse off.

djoliet

My doctors office told me the test was actually quite expensive and they only really recommended it to anyone with a family history of CF so I declined it.

conleyk7

That was a little irresponsible for your doctor to try and guess what your payment would be. I'm a doctor and, trust me, we have NO IDEA what individual insurance plans will cover/not cover. I think bringing it up to him would get you an apology but also could possibly get you a letter to your insurance company explaining the necessity of the test. Sometimes a letter from your physician can make a big difference in the cost to you. If you or your husband really want to talk about it, I would just plan to bring it up in a way that is tactful and not accusatory because nobody likes to be in that sort of a situation. Good luck!

skatergrl

Thank you everyone! I really appreciate all the advice. I still haven't heard back from the billing person. I'm hoping that means she's looking into it but I have a feeling it means I'm low priority. But we'll see what happens after I speak to her.

xomegabee1218ox

same thing happened to us,. We said no then the doctor said oh you're of Irish decent( guess that makes a difference in likelihood?) so we said okay I guess we will get it. Out of pocket $1600 later we were less than thrilled out doctor even had us change our minds considering there was no family history of it. Lesson learned for this ftm as well !

bdazzld

xomegabee1218ox said:

same thing happened to us,. We said no then the doctor said oh you're of Irish decent( guess that makes a difference in likelihood?) so we said okay I guess we will get it. Out of pocket $1600 later we were less than thrilled out doctor even had us change our minds considering there was no family history of it. Lesson learned for this ftm as well !

Yeah the only reason I had it done was I'm of Irish descent and my Irish grandfather is ALSO adopted so we have no family medical history on his side and he and my mom have passed so no way to really even try and dig. 

Turns out I'm a carrier husband isn't though--so at least we know but 400$ is a lot. 

OP--I'd definitely try to get it recoded or talk to the billing people, sometimes they can bring the bill down or let you do payments.

skatergrl

The same day I got the statement from the insurance I received a letter from the lab (Sequenom Laboratories). It said that once I get a check from my insurance to either endose it over to them or go online and pay. So it's actually them the money is owed to. I plan to call them too once I hear back from the OB billing person. The information about being of Irish decent is really interesting. I didn't know that. I'm VERY Irish so perhaps it was something I should have had done anyways.

mangomimosa

All I can say is...

ngolimento

I'd bring it up, just don't be a douche about it. Something along the lines of "Hey, we discussed that this test would be 25, but my insurance is charging me 1k. Did something get coded wrong in billing?"

Anyone who isn't a jerk would double check for you and adjust it if a mistake was made.

Mic512

DH's cousin has CF & there was no known family history before he was born. DH is a carrier, I am not but for us it was worth every penny to do the testing & have that piece of mind. We each have some unknown family history so that plays in too. Make sure you follow up with the billing person & your insurance co

Chris&Ang

You can't argue about the cost but I would discuss/argue the fact that they sent it to a lab that was out of network. I had a lot of genetic testing with my perinatologist and they confirmed the lab that was in network with my insurance before they even drew my blood. They also had me sign for it (I'm guessing they like to "cover their butt too"). Good luck!

skatergrl

Problem resolved! I called the lab a few minutes ago and spoke to a very nice lady there. It looks like I only owe the amount my insurance sent me a check for and then just $25 out of pocket. All is well. Thank you everyone for your advice.