Help negotiating medical bill!
Any pro medical negotiators out there? I'm at my wit's end.
My OB sent me for "routine blood work" after my 8 week appointment. Her office works with a medical testing company called LabCorp. I never saw the paperwork and I never signed anything. I just received a bill for $784.42 for a cystic fibrosis panel! My insurance says they don't cover it because it's not preventative maternity care and it's not listed under my benefits.
I have 3 major issues here. The first is that my doctor's office - who usually double-checks procedures before running them - did not check whether insurance would cover the CF panel since the office was not running that test itself. The second is that I never signed anything! How can I possibly be liable for charges when I didn't specifically agree to the test in writing? Finally, I have never negotiated a medical bill before. Where do I start? I see that companies like RequestATest.com only charge $359 (incidentally, I would have had my blood drawn at the exact same LabCorp facility if I had done it online). If they insist on me paying for the test, can I lobby to pay no more than $359?
Thanks ladies (and any lurking gents).
Re: Help negotiating medical bill!
I've never had to "sign off" on any bloodwork request..... Do you sign off on all blood work and doctor visits prior to walking in the exam room? When your doctor does a urine dipstick every visit, do you sign off on that charge beforehand?
Technically it's also your responsibility to check with your insurance regarding coverage prior to testing or even a physician appointment. You could have asked for a list of tests that were being ran and checked with your insurance. Sadly, in the world of insurance, that's protocol. Most people learn this the hard way.
I don't have any experience "negotiating" with insurance companies, but at the end of the day the test was ran, and they are going to want to be compensated. I'm also not sure that insurance companies "price match".
You may want to ask if this amount gets applied towards your deductible. If you were going to have to pay x dollars in order to reach your deductible, you may have just incurred charges later down the road anyway, and this just means that you meet your deductible sooner rather than later.
TFMC 08.02.13 at 19+ weeks. Everyday I grieve for my little Olive.
Disclaimer that I have never contested a medical bill before....
However to me, the first logical step would be to contact your doctor's office. Let them know that you received a bill for a test that not only were you not informed that they were doing, but that you did not authorize (and would not have if you had been informed). I would tell them that you cannot afford the test, and since it was done without your knowledge or consent, that you don't feel you should be responsible. See what they say.
All of this. I've never had the OB check with insurance on a routine basis. Yes, they've checked when I asked or before my first visit, but I wouldn't expect them to check every time and every test. Sorry about the charge. You can try and find out what the popular insurance company in your area would pay for it and offer them that in cash. I've seen it work before. They don't have to wait if you pay all at once in cash vs. credit.
But it was done with her consent. It was part of the routine b/w she did...which she knew she was doing. She should have asked what was part of it.
I would completely agree with this if the procedure had been a "standard" one done to all pregnant women...it definitely would have been the patient's responsibility to know ahead of time what their insurance covered. However a cystic fibrosis test is optional. Conducting it without consent seems like the equivalent of doing an NT scan without saying anything to the patient. When I had my NT scan done, I had to sign and initial several documents that stated what they were doing, and that I would be responsible for charges not covered by my insurance.
My clinic has often advised me when things are "commonly not covered" by insurance companies. It is possible that this test is commonly covered by other insurance providers, so if your non-covereage is out of the norm, I wouldn't expect them to know for every insurance company.
When I check in at the Dr, I sign a form that gives my "consent to be treated" or basically, consent to bill my insurance for services rendered. As PP's mentioned, you could maybe try to settle with them for a lesser amount, but sounds like if your insurance Co is pickier than the average coverage, you will want to be diligent in future appts to avoid being in the same mishap.
My 2 December boys
When you give blood you are consenting to whatever tests are checked off on the lab requisition form. If you don't ask what is being tested some of the burden does fall onto your shoulders. IMO it's completely different than a NT scan, and, not everyone has to sign and initial documents for the NT scan. Perhaps you did, but that's not a requirement. Your practice probably had an issue with people having the scan, finding out they were not covered, and then refusing to pay.
TFMC 08.02.13 at 19+ weeks. Everyday I grieve for my little Olive.
I work in health care... that being said... yes it they will say it is your responsibility to check and make sure tests are covered.
I'm not saying this will work in all instances or will for sure work in this instance... but wait as long as you can to pay the bill. If you go a few months with not making a payment, then they will be more willing to take a lower amount. They might even be willing to write off the entire amount... The average return on billed charges is 27% in the healthcare industry. The only thing is... i don't know if lab corp reports to your credit. I'm assuming on a bill that low they will not, but its possible.
So you can either wait it out, and likely not pay much... or call and try to negotiate with them right off the bat. They may be willing to take a lower amount... Or if they're being super strict they may require you to pay the full amount regardless.
OK, waiting to pay the bill is a really bad idea.
I work for an insurance pricing company. Generally Lab bills are really expensive because they give insurance companies really deep discounts. Like 70 to 80 percent sometimes. I would first try telling them that you will not pay more than Usual and Customary since you were unaware your insurance would be denying the charges. I would be willing to be the U&C charges are less than $359. If I had the actual codes used, which usually providers don't tell patients, I could tell you what we are contracted with them for but I don't know that they would give you the codes. Healthcare is a crazy...
I wouldn't suggest making a habit of it, or trying it with any other type of industry. I've worked in finance my whole life. However...Healthcare... Especially right now is a completely different ball game so to speak. It also will vary company to company.
This response makes the most sense to me. I'd contact Labcorp to do negotiations directly with them. Your doctor's office won't be able to help you since you are being charged directly from labcorp, and the test was done in your name. Do wait to pay the bill while negotiations are going on- it is common practice in healthcare to at least wait until you get an explanation of benefits from your own insurance before paying a bill anyway, and as long as you get evidence of your price negotiation on paper (or email) you can argue against it affecting your credit.
It might be worth it to ask to see a copy of the order just to make sure that the Cystic Fibrosis test was actually ordered and not run by mistake.
This is why healthcare costs are skyrocketing. I am sorry you are being billed for something you didn't know you would be billed for, but it is your responsibility to know what tests are being done. Please pay the bill if you are responsible for it, because collection agencies do get involved and your credit can be messed up. One of my friend's DH has bad credit because of a medical bill that remained unpaid.
Are you sure your insurance isn't paying for it? DH told the person in HR at his job that I am pregnant and she said that if we get any bills from Lap Corp to make sure that our insurance didn't cover it. She said sometimes they send you the bill hoping you will pay it without always submitting it through our insurance. They apparently find some kind of loophole. She even gave him a phone number you can call to check to see if you should be paying Lab Corp's bill and if so, how much you should be paying. I have it somewhere in the house but I'm not positive where. I wasn't there and DH was rambling when he told me this so I am not 100 percent sure I understood what his HR person told him.
I worked in a doctor's office. We only checked people's insurances for major things like x-rays or CAT scans. If your insurance didn't cover it, it is unfortunately your responsibility. If you talk to your insurance and there is not much you can do, I would pay it. You don't want to go into collections.
Op, from another person who works in healthcare, this is exactly how you handle it and you will succeed if you do this. I have negotiated many of my fathers medical bills as well using this method... There was a mistake in setting up his Medicaid and many of his claims were rejected.
Contact them now and state that you will pay the usual and customary, and that is all you can afford. And if the person you speak to says no, ask for a manager. Then just rinse and tepeat til they agree. The amount you owe will go down significantly.
Learn from this and next time ask lots of questions and read all the fine print in advance! Good luck w your negotiating!
ugh! I feel your frustration. I just spent over an hour on the phone with my insurance trying to figure out why my son's medication was no longer covered. Apparently we are only allowed 3 refills of one type of prescription...WHAT? That is such crap I can hardly believe it. Coverage is getting to be such a pain. We are paying so much money every month with high deductibles only to be told that many things we need our not covered anymore!
Good luck to you. I agree that you should call Labcorp and offer to pay the price you saw online (which is very fair) and tell them that is what you can afford right now. There is no reason they should be charging that much for one test. Get the new amount owed in writing that it is the full amount to settle your debt before you send them any money. And don't give them access to your accounts.
This is true. When I worked in the doctor's office, sometimes it was as simple as changing the code.
I could go on and on about this. I'm a nurse on a military base and unfortunately the majority of my job is referral and codes for billing Tricare (military insurance). My recommendation would be to first contact your ordering provider's office, let them know it was denied and like pp said have them submit a DX (diagnosis) code that will show the testing was necessary. I change codes all day long, honestly, just to keep patients happy. Second, if for some that test is simply "a non-covered benefit" THEN try to negotiate with Labcorp. Ultimately, like everyone said, it is your responsibility. There are certain offices that will obtain a signature (quest is one) stating that you understand and accept any charges that insurance doesn't cover, but that's solely to avoid conflict, they don't HAVE to do that. Good luck. Make sure you ask for codes before having any testing or anything else done. You can tell by the posts on this board that everyone's coverage is different as we all have different tests being done and some of us are paying for things that other insurance companies cover.