Health Insurance bill ?......is this normal?

[Kitty 34]

We just switched a year ago to Blue Cross so am still trying to figure out exactly what they pay for and what not.


Well anyway......I had some procedures plus lab work done over the late summer/early Sept. We collected all the bills and just 2 weeks ago paid all of them as we hadn't met our deductible yet.

Today I get a bill from the lab; the one that we had already paid their bill in full 2 weeks ago. So was hoping they were just acknowedging this.

Nope, not the case. We owed $54 more. (They had received our payment) I took this new bill and compared it with the bill we paid and gee they had tacked on another "fungal growth whatever" to the list of lab things they did on Sept 10??? There had been 6 tests run that day.

It's too late to call today but why the heck wouldn't this test have been with all the others??

It's just discouraging as we had taken $1,000 out to pay for all these bills and felt we were finally caught up!

 

[sam_gordon]

We just switched a year ago to Blue Cross so am still trying to figure out exactly what they pay for and what not.


Well anyway......I had some procedures plus lab work done over the late summer/early Sept. We collected all the bills and just 2 weeks ago paid all of them as we hadn't met our deductible yet.

Today I get a bill from the lab; the one that we had already paid their bill in full 2 weeks ago. So was hoping they were just acknowedging this.

Nope, not the case. We owed $54 more. (They had received our payment) I took this new bill and compared it with the bill we paid and gee they had tacked on another "fungal growth whatever" to the list of lab things they did on Sept 10??? There had been 6 tests run that day.

It's too late to call today but why the heck wouldn't this test have been with all the others??

It's just discouraging as we had taken $1,000 out to pay for all these bills and felt we were finally caught up!

I personally think the problem is with the lab, not with the insurance. Contact the lab and tell them you paid the bill in full on 'x' date, why are you now getting an additional bill? I don't think you'll get very far, but that's where you need to go (IMO).

Can you contact the doctor and confirm they wanted that test ran?

 

[daughter_of_amid_chaos]

I had this same issue with a lab last year also under blue cross blue shield insurance. Turns out the original person at the lab had filed my paperwork wrong so things that the insurance was supposed to pay for didn't get included into it and I ended up getting a second bill after I had paid in full the original bill. Took 1 phone call to the lab's billing service to get it figured out and I didn't have to pay any additional funds.

 

[Peanut Giggleface]

This doesn't sound like an insurance problem but a billing problem. If they did complete that additional test but it wasn't on your original bill, then it's an error on the lab's part. They have to bill for it as it was a service that was provided to you, regardless of whether or not your deductible has been satisfied. You should receive an Explanation of Benefits (EOB) from BC/BS showing the breakdown of services provided and any discounts the Dr. and the lab gave you as a policy holder. It will also show you how much of your deductible has been covered. We've had BC/BS for years and that's how it's always been handled for us.

 

[Heidict]

It's possible that this particular charge was still pending with the insurance when you received and paid the other bill. Often, medical places will not bill you for a service until they receive word from the insurance about how much you owe. They would have no way of knowing otherwise.

I would call their billing department tomorrow. Also check your eob from bcbs to see if this particular charge was paid at another date then the original tests. You should also be able to tell when they submitted the charge to see if they submitted them all at the same time.

If you are questioning whether or not your doctor ordered this test, call him to verify. It is also possible that this test was run due to the results of another test that the doctor did order. It may not have been originally ordered by the doctor.

 

[Lynne M]

As a former medical technologist....

Sometimes the results of one test require a follow up test to confirm the original result, or to further develop the diagnosis. This is particularly true in microbiology. You do a gram stain or a culture, it comes back indicating a fungal infection, now you have to do a subculture on different media to grow out the fungus so you can identify it. There are materials and labor involved in doing that fungal culture, so they have to add a charge for that.