I am freaking out! Has this happened to anyone else? Insurance has denied coverage for the Panorama genetic testing we had done back in August and we got a bill from Natera for $8,000! We cannot afford that!
When our doctor recommended the test (due to age-I’m 35), we asked if it’s typically covered by insurance. She said yes, it is. She told us we should expect to pay $100-$200 at the most. I feel blindsided! Is there anything I can do to get out of this? Please help!
Sounds like this would be a good topic of discussion with your insurance company not internet’s strangers...
You can call insurance but it will likely be covered as out of network at best. Don’t be surprised if they denie it though due to a lack of pre authorization. You can call the company the performer the test and discuss a discounted rate or payment plan. With any non-routine testing you should ALWAYS call your insurance company to discuss if a pre with is need or if any other req need to be meet beforehand.
Yup. Insurance company call would have my first phone call...not asking a bunch of women who have absolutely no idea how to help you.
I guess maybe 1 helpful suggestion may be to start a payment plan with your billing hospital or office. Medical bills do not accure interest so take as much time as you need to pay it off if the insurance company still won’t cover the test.
I also can’t believe you are 35 and still don’t know that you should ALWAYS verify to see if a procedure will be covered by your insurance. And at some OB offices, THEY will check it out for you. Don’t ever listen to someone who says “insurance companies usually cover” xyz. They don’t know what type of insurance you have.
Also to support what others have stated and to add...it is/ was your responsibility to check with insurance before having test done. That's not drs responsibility. I'm sorry you were Ill prepared and didn't do your homework. Ps. I'm also 35 and that's not a reasonable excuse.
My dr office was proactive and gave all the recommended tests and the billing codes. They were explicit in saying to check coverage first. I have great insurance and the Panorama / Materni23 tests required doctor approval to be submitted to an insurance medical review board before they would pay for it. Call the insurance. figure out what would be needed to appeal. You might need to have your dr file paperwork. Call Panorama and see if they have anything to say on whether it can get reduced. Sucks but you have a lot of work ahead of you to resolve.
Me: 33 DH: 31 DS: 5 years old TTC #2 since August 2015 July 2016: Testing cycle with 100 mg Clomid = BFN August 2016: 50 mg Clomid + IUI = BFN October 2016: IVF#1 - 13 retrieved / 12 mature / 9 fertilized / 2 blasts November 2016: FET#1 = chemical January 2017: FET#2 = chemical March 2017: IVF#2 - 18 retrieved / 18 mature / 16 fertilized / 5 blasts
April 24, 2017: FET#3 - BFN May 24, 2017: FET#4 - BFP! - Beta #1 151 - Beta #2 503 - Due date 2/9/18
Lurking to say -- this is common and you shouldn't, as others have suggested, move right to setting up a payment plan. They likely billed you the full amount they attempt to bill insurance companies (even they do not pay that much) as opposed to the amount they bill people whose insurance doesn't cover it. Call Panorama and your insurance company.
My Materni23 was declined because my insurance didn't cover it for twins. My doctors recommended it anyway so I did it and in the end I paid $250. They warned me that I might get a crazy high bill at first but just to call if that happened.
Re: Panorama testing not covered!
You can call insurance but it will likely be covered as out of network at best. Don’t be surprised if they denie it though due to a lack of pre authorization.
You can call the company the performer the test and discuss a discounted rate or payment plan. With any non-routine testing you should ALWAYS call your insurance company to discuss if a pre with is need or if any other req need to be meet beforehand.
I guess maybe 1 helpful suggestion may be to start a payment plan with your billing hospital or office. Medical bills do not accure interest so take as much time as you need to pay it off if the insurance company still won’t cover the test.
I also can’t believe you are 35 and still don’t know that you should ALWAYS verify to see if a procedure will be covered by your insurance. And at some OB offices, THEY will check it out for you. Don’t ever listen to someone who says “insurance companies usually cover” xyz. They don’t know what type of insurance you have.
Good luck.
Ps. I'm also 35 and that's not a reasonable excuse.
DS: 5 years old
TTC #2 since August 2015
July 2016: Testing cycle with 100 mg Clomid = BFN
August 2016: 50 mg Clomid + IUI = BFN
October 2016: IVF#1 - 13 retrieved / 12 mature / 9 fertilized / 2 blasts
November 2016: FET#1 = chemical
January 2017: FET#2 = chemical
March 2017: IVF#2 - 18 retrieved / 18 mature / 16 fertilized / 5 blasts
May 24, 2017: FET#4 - BFP! - Beta #1 151 - Beta #2 503 - Due date 2/9/18
My Materni23 was declined because my insurance didn't cover it for twins. My doctors recommended it anyway so I did it and in the end I paid $250. They warned me that I might get a crazy high bill at first but just to call if that happened.