I'm sorry...as a Canadian most of ours is automatically covered. PSA tests for men have to be paid for but if they come back positive for cancer, you don't have to pay. In that case paying is good news.

I wonder if you explained this to your doctor, if he let the insurance company know why he felt that these tests were important for him to order for you if they would then cover them. I wish I could help more. I hope the tests came back normal for your sake.

I would definitely talk to the doctors office because they know your insurance company and should be aware of that when ordering any type of work done, they should tell you if it is an out of service provider on your insurance and you should have the option to have another lab do the work.
At the very least the lab needs to know you are having to foot this bill they will often significantly reduce the amount when this happens and insurance is not paying.
I had one lab that told me they would just write it off for me not to worry about it, I said oh no I want to pay my share but the lady was very nice and said not to worry they can do that in certain cases and mine was one of them. I was happy I had called!

Definitely discuss it with the doctor's office. It could be that the doctor could justify the expense to the insurance company because of your medical situation. Good luck...and welcome to the KT!

I would fight the doctor's office tooth and nail. There is no way you should be responsible for this. Be tough!

If your health insurance is thru your employer, I would speak to the person there who handles health insurance. Most employer sponsored plans have coverage for "out of network" providers, but just cover LESS than if you go to "in-network". (If it is a private policy, call your agent for assistance.)

I would also speak to the "insurance person" @ the Dr's office AND I would talk to the lab that will be billing you for their testing services. Sometimes out of network providers will agree to reduce the patient's responsibility for charges to the same level as if they had been in-network providers.

It is just ridiculous the barriers that insurance companies throw out to make life complicated & miserable for the dr's, labs, other providers, AND the patients. No way can any of us keep up with all the minutiae. They do this to pump up their profits.

When you talk to these various entities be sure to keep PRECISE NOTES of date/time/person you talked to & what was said. If the person isn't helpful, ask to speak to a supervisor.

Also... you've only appealed once. I doubt that you've exhausted all appeals. Appeal til the cows come home...... squeaky wheel gets the grease, ya know.

If ALL else fails, pay them $5.00 per month.....

Good luck! (And welcome to the KT)

I agree with others. Find out WHY the Dr. sent the blood work to another lab without checking to see if your insurance would pay. Do they do certain test he/she wanted that the original lab can't/won't do? Are they a friend of the Dr? Was he unhappy with the original labs work? Did he get a kick back? (yes that does happen). You also might call the lab's billing office and tell them you were not notified about the change and you did not authorize this work without checking with your insurance company. Write everything down. Are you still ok with your Dr.? or are you going have to find a new one. Be firm but pleasant when you call. Let us know what is going on.
Good luck
M.

Welcome, JoniG. You already have lots of good advice but I wanted to say we're glad you're here and hope the test results were good.

Did your doctor give you any indication if and why he was ordering more extensive blood tests than usual? Was there some condition he was concerned about? Could the tech drawing the blood have made a mistake about which tests to run and where to send the blood?

All of these questions need to be asked of the doctor's office.

As was said, we don't have to worry about that in Canada. I wish you luck sorting it out, and welcome to the KT.

I would check and see if the doctor had any ownership in the lab.....if so I would report him to the medical quality assurance board in your state.

Thank you for all the great ideas. I tried to call the Dr's office today, and reached his service who told me the office will be closed till after the 1st. But I will call the Lab tomorrow and start with them..Perhaps they will "write it off" for me, like they did for Ravencajun..I'll re-post when I have news. Thanks again...you're a wonderful group.

A big welcome from me too!

Hope all works out with the Dr's office.

If you were under the impression you were just having routine blood work done and it would be covered, I would talk to your doctor's office. First off, why did they send it to a different lab? Was the old lab was taken over, or did the regular lab not do the extensive tests and they had to send it out?

I have a feeling the office can resolve it. I wouldn't start off off "tough" though. I'd be really sweet because the office may have total control how to handle this. You can always get tough later if it doesn't get resolved to your satisfaction.

I'm going to echo argue this with the Dr. office. I've had times where the Dr told me to see a specialist who happened to be working in the ER that day...got charged an ER visit. I argued and got charged a dr visit (office visit vs er visit). other time friend son had surgery. Anesthetist was out of network, but everyone else plus hospital was in network. So one part was going to be charged out of network charges. She argued that she had no choice in the matter, and was following in-network practices. Anestastist was covered as in network.
SO if you argue that you thought this was routine bloodwork due to not being informed (do it in writing and keep a copy) you may get things covered by Dr. office or insurance to re-consider if Dr. office will contact them.

Vickey

When I was pregnant, the doctor couldn't find my baby's heartbeat and sent me to a different hospital for a special fetal sonogram. Turns out it was "out of network" so I got a bill for $2000. I wrote a letter to the doctor, the hospital and my insurance company , but it did no good. Not wanting to damage my credit record, I paid the $2000 out of my savings. It hurt but I was happy I had no bad debts AND my baby was born healthy. Aboyt two years later, I was very surprised when the Insurance Company refunded my money, the full two grand! . Aparently someone "else" stepped forward and challenged them, so they reviewed past policy and gave me back my money. From the little I know about debt collections, you can pay them Five or ten bucks a month and they cannot sue you, as long as ou are at least paying "Something." Good luck!

I am so glad we don't have to deal with insurance companies in Canada.

I am so glad we have the freedom to deal with insurance companies; it means choice! :)

I do medical billing and anything can be written off. In this case though, you don't have a relationship with the lab like you do the doctor, so I don't know how willing they will be to do so. I would definetely have a conversation with the doctor. Good luck; it can be intimidating, but persevere! :)

After reading everyone's advice, I am going to wait till the Dr's office reopens next week and start with the Dr and see what happens after I speak to him, perhaps he will be willing to either contact the lab or my insurance co. I won't give up , as I don't have the money to pay this lab bill, So something has to be done. I post when I have some more info to share.

This Canadian has no advice to offer - but welcome to the voicing part of this place (as you've been around for while).

Feel free to join in the fray any time that you feel like it.

I hope that you can get the issue straighteed out to where the charge is reduced substantially, if you get stuck with paying.

ole joyful

P. S. Move to Canada, maybe?

Rather ... you should have moved to Canada last year ...

... but, even so, you might have had to pay some, at least, as not everything is covered.

I have a choice of where I go for service.

I've been paying for my PSA tests for some time ... and, in the light of the post earlier, glad to part with that $40. annually.

o j

"I am so glad we have the freedom to deal with insurance companies; it means choice! :)"

Just to explain... we have choices too. We can go to any lab, we can get a second opinion, we don't have to worry about any "network" issues when we are referred to a specialist. Pros and cons to both ways, but we certainly have choices. By December I will have had three MRI's on my head in less than a year... All I have to worry about is getting better.

Susan, I and many, many Americans are envious. (That is NOT sarcasm. I just might get in trouble if I go further.)