Doctors & Insurance

eiramami

To preface, obviously you want to do all your own research to be informed and blah blah blah but... 

...will doctors tell you if you're not covered for something (NT Scan for example) or do they just do it and you find out who covers the bill after the fact?

Heddarc

My Dr didn't do my NT scan because they had to send me to a High Risk Fetal Medicine practice.  The letter I got from them to set up my appt said in all caps and bold, "You are responsible for contacting your insurance company for costs blah blah blah".  So, I had to call the insurance company myself to find out.

dixee.deluxe

Nope.

I got billed a $50 copay for my first ultrasound.  I didn't know until after the fact.  I called my insurance company and they said I did have a copay.  I told them I never did before (uh, I was, like JUST pregnant) and they said I did.  Well, I DIDN'T!

I had already had my NT Scan and asked her if I'd be billed for that (I wasn't last time).  They said they didn't know and wouldn't know until they got the bill.

If I get billed, I'm calling again.  Ugh, insurance.

funkymonkeyohyeahhh

My doctor and her staff have a lot of people with my insurance, so they have a general idea of what is covered/what is not. They told me at my 10w5d appointment that if I wanted the NT scan they would have to get it authorized by insurance or the cost would be over $1,000. Within 20 minutes they had it authorized. I'm not sure what they did, but now it is covered.

That being said, I have visited other doctors before (non-pregnancy related) that didn't say anything at all. I did things during the appointment because they were asking me to, and once I received the bill I thought, "Well, I wish I would have refused that." 

Tambcat

I guess they tell me, but there haven't been too many things that weren't covered. Ultrasounds and labs are covered 100%. They told me at the first appointment that there'd be a copay for each visit (which I gather from the Nest is unusual) and that if the baby was a boy and I wanted him circumcised, I'd need to add him to my health insurance plan b/c otherwise it wouldn't be covered. I asked about the NT scan just in case b/c I wasn't sure if it was considered medically necessary, and they said it was covered.

mamabear0813

generally no, the office will just do what they do and it's up to you to know if it's covered or not. If you have a popular insurance they may know from experience, but usually they'll tell you to call your insurance provider.

westrose

I called my insurance company to have a general idea about what is covered and not. They were very helpful and if I have any questions I would call again. 

I recommend calling and not counting on the doctor to tell you.  

JFH2010

In general (not just with babies) I'm surprised by how often doctors don't check on insurance stuff for you. I've found that when they do, it's much faster/easier - they know exactly what codes they're going to put in. I've called my insurance co a few times and they don't always know what I'm talkng about if I don't have the medical code. But I've had a number of things randomly not covered, so I agree with pp, it's best to call.