$495 LAB Test, Am I Stuck With The Bill?

[gagsme]

What is the name of your state (only U.S. law)? california
Doctor recommends a genetic test for my condition. After taking blood samples, he tells me not to submit bill to insurance company. After seeing him, I went to the front office to pay the bill. I was shocked at the large bill. It was several times more than the consultation price I was quoted over the phone. When he saw me struggling to pay, he just handed me a medical credit card application.

I DON'T FEEL I SHOULD HAVE TO PAY THE WHOLE LAB BILL FOR SEVERAL REASONS:

A. HE NEVER TOLD ME THE PRICE($495) PRIOR TO TAKING SAMPLES.

B. HE NEVER SUGGESTED HOLDING OFF ON SENDING SAMPLES TO LAB.

C. HE ONLY TOLD ME AFTER TAKING SAMPLES, INSURANCE WOULD NOT PAY.

D. SOME OF MY SYMPTOMS INCLUDED BRAIN FOG, WEAKNESS AND DIFFICULTY MAKING DECISIONS. HE WAS WELL AWARE OF MY SYMPTOMS.

AM I RESPONSIBLE FOR THIS BILL?

 

[ecmst12]

Caps lock is unneccessary.

Yes, you consented to the test and are responsible for the bill. You don't KNOW your insurance won't pay unless you submit it to them, but it was your responsibility to find out what would or would not be covered before consenting to the test.

 

[lealea1005]

Lab tests are expensive. The cost comes from the diagnostic lab to the Doc and, believe it or not, $495 may be his discounted rate from the lab that he's passing along to you. It could be, if the cost came directly from the lab to you , it would be much higher.

He cannot "hold off" on sending you sample to the lab because the blood sample will deteriorate and be unusuitable for testing.

Most insurance companies do not cover genetic testing.

You are responsible for the bill.

Good luck. I hope you are diagnosed and on your way to treatment soon.

 

[barry1817]

testing

What is the name of your state (only U.S. law)? california
Doctor recommends a genetic test for my condition. After taking blood samples, he tells me not to submit bill to insurance company. After seeing him, I went to the front office to pay the bill. I was shocked at the large bill. It was several times more than the consultation price I was quoted over the phone. When he saw me struggling to pay, he just handed me a medical credit card application.

I DON'T FEEL I SHOULD HAVE TO PAY THE WHOLE LAB BILL FOR SEVERAL REASONS:

A. HE NEVER TOLD ME THE PRICE($495) PRIOR TO TAKING SAMPLES.

B. HE NEVER SUGGESTED HOLDING OFF ON SENDING SAMPLES TO LAB.

C. HE ONLY TOLD ME AFTER TAKING SAMPLES, INSURANCE WOULD NOT PAY.

D. SOME OF MY SYMPTOMS INCLUDED BRAIN FOG, WEAKNESS AND DIFFICULTY MAKING DECISIONS. HE WAS WELL AWARE OF MY SYMPTOMS.

AM I RESPONSIBLE FOR THIS BILL?

I am troubled that the doctor was telling you not to submit the bill and what was his reasoning behind this statement. Normally an office submits the insurance payment on behalf of the patient as they have the specific codes for procedures.

If he told you not to submit the bill, because he knew that the test wouldn't be covered, he could have told you the fee before hand and you would not have been surprised by the cost, and since a doctor controls the whole office and is responsible for all those that work for him, he should have had the costs available to you.

If he did not know that the test was covered, why is he telling you not to submit the bill.

Something doesn't make sense here.

 

[lealea1005]

I am troubled that the doctor was telling you not to submit the bill and what was his reasoning behind this statement. Normally an office submits the insurance payment on behalf of the patient as they have the specific codes for procedures.

If he told you not to submit the bill, because he knew that the test wouldn't be covered, he could have told you the fee before hand and you would not have been surprised by the cost, and since a doctor controls the whole office and is responsible for all those that work for him, he should have had the costs available to you.

If he did not know that the test was covered, why is he telling you not to submit the bill.

Something doesn't make sense here.

Submitting claims is NOT free. Unless submitting claims is specifically addressed in the Doc's contract with the insurance company, s/he is doing it as a courtesy. Perhaps the Doc wasn't in network with OP's insurance plan...OR... (as often happen in these parts) the diagnostic laboratory may not be in plan. That is all speculation on my part. Maybe OP can answer that for us.

In any event, $495 is quite reasonable for genetic testing.