Who is responsible?

[TinkerBelleLuvr]

What is the name of your state (only U.S. law)? Florida

I had a physical done in April. While there, we discussed that I had to use Labcorp as my lab. With that said, the nurse practitioner said that I would have to go to Labcorp to get the blood draw. Okay. Turns out that they sent the other test to Quest and of course, insurance won't pay. It was in my chart to use Labcorp. I discussed in when in there on that day. Personally, it was their mistake and I shouldn't be liable for it. And because it was a physical, insurance would pay 100% of the charges as long as the visit was a physical, which it was.

I already had issues with this office. They double billed the insurance - one for the physical and one as an office visit because the billing clerk saw prescription medications mention. As part of the questions by the nurse, we DID discuss what meds I was on (as expected.) No scripts were written for meds. The second visit as taken care of.

Do I have a leg to stand on to request that the doctor's office pick up the cost since they made the mistake?

 

[Ohiogal]

What is the name of your state (only U.S. law)? Florida

I had a physical done in April. While there, we discussed that I had to use Labcorp as my lab. With that said, the nurse practitioner said that I would have to go to Labcorp to get the blood draw. Okay. Turns out that they sent the other test to Quest and of course, insurance won't pay. It was in my chart to use Labcorp. I discussed in when in there on that day. Personally, it was their mistake and I shouldn't be liable for it. And because it was a physical, insurance would pay 100% of the charges as long as the visit was a physical, which it was.

I already had issues with this office. They double billed the insurance - one for the physical and one as an office visit because the billing clerk saw prescription medications mention. As part of the questions by the nurse, we DID discuss what meds I was on (as expected.) No scripts were written for meds. The second visit as taken care of.

Do I have a leg to stand on to request that the doctor's office pick up the cost since they made the mistake?

Dispute the charges in writing to the doctor's office. Start with that. Point out that they attempted to double bill the insurance. Point out that the notes state they are to use Labcorp.

 

[TinkerBelleLuvr]

The key here is that I used an in-network doctor. Per the insurance company, they will resubmit for consideration because I used an in-network doctor and THEY did the submission to Quest.

 

[cbg]

We discussed this offline, Tink, but for the benefit of the masses;

Tink is off the hook because she expressly asked for an in-network facility to be used, and she even went one step better and identified a facility that the doctor has been known to use and is in her network. Had she not done so, it would be too bad so sad. But she did; she took the initiative and the doctor dropped the ball. Tink is not responsible.

The vast majority of people who post here with this question did NOT do their research, take any initiative or talk to the doctor and just assumed that the doctor would know what labs were in network for their insurance and send it out accordingly. That's not Tink. Therefore, Tink gets a different answer than most folk get.

 

[TinkerBelleLuvr]

Thanks cbg.

I want to add some additional information to benefit others. I had gone to the doctor for a physical. I made a bad assumption that the nurse practitioner would order blood test that would be considered "routine" physical test so that it would be covered 100% by insurance. WRONG. So, per the advise from the insurance company.

Do NOT have the blood drawn at the doctor's office. Instead, get the prescription for the tests they want done. Next, call your insurance company and check the codes with the insurance company. They will tell you how it will be covered (or not.) If not, then have them write the prescription for the correct blood tests. In my case, only 1 of the 4 tests were covered. Then of course when all is good, go to the lab that is covered by your insurance company.

 

[TinkerBelleLuvr]

We discussed this offline, Tink, but for the benefit of the masses;

Tink is off the hook because she expressly asked for an in-network facility to be used, and she even went one step better and identified a facility that the doctor has been known to use and is in her network. Had she not done so, it would be too bad so sad. But she did; she took the initiative and the doctor dropped the ball. Tink is not responsible.

The vast majority of people who post here with this question did NOT do their research, take any initiative or talk to the doctor and just assumed that the doctor would know what labs were in network for their insurance and send it out accordingly. That's not Tink. Therefore, Tink gets a different answer than most folk get.

The other part was that I had used an in-network doctor.

 

[cbg]

That in itself would not be enough to take you off the hook for an out of network lab if you had not discussed with the doctor which lab to use.

 

[TinkerBelleLuvr]

That in itself would not be enough to take you off the hook for an out of network lab if you had not discussed with the doctor which lab to use.

I agree with that. I'm referring to having to pay additional fees on other lab work (done at the in-network lab) that landed up costing more than the $0.00 I was expecting.