Insurance Question

hollymichael · July 2009

Sorry for the boring post, but I have a question. As you know, I have been seeing the gyn instead of the RE in an attempt to get coverage for some of my fertility testing/treatment before the coverage actually kicks in this November. Well, it turns out most of my lab work was not covered b/c the dr.'s lab is out of network. Go figure! This is what I get for trying to be sneaky with my insurance co. At least it wasn't very expensive.

What do I do in the future? Can I ask the dr. to send the orders to a different lab where I am covered and then have the results sent to him? Is anyone else in this situation?

TIA

panda246 · July 2009

Me...

Get the complete documents from your HR or benefits department for you insurance coverage. In those docs. it will state who the preferred lab is for blood work. If you can't find it, call your insurance company. Your doctor can write you a script to take to the preferred lab.

For us, it's Quest Labs. My RE is totally cool with having my bloodwork done at Quest. He just wrote on the script for them to fax the results to him. I'm having my first blood work done there on Thursday. Hopefully it all will go as smoothly as it sounds like it should be.

Dochas · July 2009

I really don't think it should be a problem to use a lab that your insurance will cover. My doctor's office is really good about working with insurance. No point paying more than you have to - I would definitely ask.

Lucky&Lola · July 2009

I wouldn't think it would be a big deal. Most gyn's and RE's understand about the insurance thing when it comes to fertility. Like PP said, get a list of labs that are covered and have him refer you to one of those. I'm sure they'll work with you.

panda246 · July 2009

Lucky&Lola:
I wouldn't think it would be a big deal. Most gyn's and RE's understand about the insurance thing when it comes to fertility. Like PP said, get a list of labs that are covered and have him refer you to one of those. I'm sure they'll work with you.

I could be wrong be you shouldn't need a "referral". As long as you are at the lab your insurance prefers, you can just go with a script.

hollymichael · July 2009

Thanks everyone!

Next time I need lab work, I will ask him if he can send me to one of the labs where I have coverage.

FrannyS · July 2009

I work in insurance and Panda's answer is spot on. You can take the doctor's script to any lab but call your insurance company first to find out what labs are in-network. There is no need to go OON for something like labs.

hollymichael · July 2009

FrannyS:
I work in insurance and Panda's answer is spot on. You can take the doctor's script to any lab but call your insurance company first to find out what labs are in-network. There is no need to go OON for something like labs.

Thanks Franny. I didn't even think to ask about it. I just assumed if the dr. was in network, his lab would be too. Found out the hard way.

MDBeachbride · July 2009

I kinda think your drs office screwed up by not sending your blood work to the correct lab the first time around. That's why they want your insurance info. There's no reason they had to send to Lab Corp vs. Quest, for example. I only say this because once, I switched insurance and they didn't pay attention and kept sending my lab work to the wrong insurance company until I caught on.

leslieb923 · July 2009

I agree that someone in your drs office isn't on the ball. ?Most offices know which insurance companies participate with which labs. Good Luck!

hollymichael · July 2009

leslieb923:
I agree that someone in your drs office isn't on the ball. Most offices know which insurance companies participate with which labs. Good Luck!

Good point. My insurance co. is a major one so you would think someone would have mentioned it.

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