MrMonk
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Tue Apr-22-08 11:56 PM
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I'm looking for input regarding a health care management situation. I can't think of a more appropriate place to post, since "Health" seems to be devoted to anything but real-world health care.
Here we go:
My old HMO had a "no fee" arrangement with only Lab A. My new HMO has a "no fee" arrangement with only Lab B.
The office staff at the medical group to which my primary care physician (PCP) belongs sent my tests to Lab A. Being familiar with my new insurance plan, they should have known to send the tests to Lab B.
I hold in my hand a $720 bill (over 30 days past due) from Lab A for the test fees. My new HMO will not reimburse because they do not pay for out-of-network services. As is true for most people, I simply do not have the money to pay those fees.
Here are the (non-exclusive) options that I see:
a) Press the medical group to absorb the entire cost. (Their business office tells me "tough luck", and that my PCP cannot intervene.) b) Continue to insist that my PCP intervene, until I get a satisfactory resolution. c) Try to negotiate the price with the lab, and eat the difference. d) Try to stiff Lab A (unsatisfactory from an ethical perspective, and almost certainly illegal). e) Bring a lawyer into the process (for $720? Probably not worth it.) f) Give up and pay the bill.
I've already decided to disassociate entirely from this medical group, and write a complaint to the HMO, if the medical group does not satisfy me before I get my next bill. I will probably do that no matter what the outcome. It's a damn shame because I've had a very good relationship with my PCP over a number of years, and he made sure that I was well taken care of during my hospitalizations.
Based on the experiences of the people in this group, which course of action should I pursue, and what are my chances of success? Is there any other person or agency that I should bring into the process?
Thanks in advance for a thoughtful response.
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sandnsea
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Wed Apr-23-08 05:19 AM
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You can't be responsible when your medical provider screws up. Contact the administration, legal, everybody, top to bottom, and if they don't eat the bill - go to small claims court.
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elleng
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Wed Apr-23-08 07:41 PM
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2. I agree with sandnsea; |
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go first to admins who made the error, and request their assistance in 'righting' this 'wrong,' in whatever way they choose.
Do it in writing, politely, of course (and send copy to your doc, if you'd like.) And send copy to Labs. Good luck.
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mopinko
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Thu Apr-24-08 10:02 AM
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3. i agree as well, but in the meantime |
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i would maybe go ahead and pursue c. of all the things in my plan that my insurer get a huge discount on, lab fees are #1. depending on what those tests are, bcbs probably would pay less than $200. i agree with those above, tho, you have no control over where you blood gets sent. hmo probably only pays the lab some chump change amount, too.
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Warpy
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Sat Apr-26-08 05:41 PM
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4. "C" is your best option |
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Call the business office and explain the situation. Often they will negotiate a lower price because they know they can't get blood out of a stone.
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DU
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Mon May 06th 2024, 03:54 AM
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