topic Re: Who's Responsible in Community Chat

Who's Responsible

Jordan2 — Tue, 29 Aug 2017 22:22:48 GMT

My motto is if it weren't for bad luck I would have no luck at all! It doesn't matter what health insurance I have, something goes wrong. I went to the gynecologist July 25, I had my woman's wellness visit and had a pap smear. Well today I get a bill from Quest Lab for $535.53! The problem is Quest is out of network for my insurance. I called the insurance company and Quest didn't even file a claim with them! Shouldn't the doctor's office know which lab to send the specimen to? Now I have to call the lab and give them my insurance information and have them bill the insurance company, then take it from there.

Re: Who's Responsible

Blingqueen023 — Tue, 29 Aug 2017 22:26:50 GMT

@Jordan2 wrote:
My motto is if it weren't for bad luck I would have no luck at all! It doesn't matter what health insurance I have, something goes wrong. I went to the gynecologist July 25, I had my woman's wellness visit and had a pap smear. Well today I get a bill from Quest Lab for $535.53! The problem is Quest is out of network for my insurance. I called the insurance company and Quest didn't even file a claim with them! Shouldn't the doctor's office know which lab to send the specimen to? Now I have to call the lab and give them my insurance information and have them bill the insurance company, then take it from there.

I work for a doctor and we always check on what insurances different labs takes. It's also the patient's responsibility to know what companies your insurance is in network with. You took the insurance out so I would assume you know what they cover and what they don't cover. I wouldn't have taken Federal Blue Cross without knowing what blood labs they participate in and what doctor's are in network.

Re: Who's Responsible

Jordan2 — Tue, 29 Aug 2017 22:37:02 GMT

@Blingqueen023 wrote:
@Jordan2 wrote:
My motto is if it weren't for bad luck I would have no luck at all! It doesn't matter what health insurance I have, something goes wrong. I went to the gynecologist July 25, I had my woman's wellness visit and had a pap smear. Well today I get a bill from Quest Lab for $535.53! The problem is Quest is out of network for my insurance. I called the insurance company and Quest didn't even file a claim with them! Shouldn't the doctor's office know which lab to send the specimen to? Now I have to call the lab and give them my insurance information and have them bill the insurance company, then take it from there.
I work for a doctor and we always check on what insurances different labs takes. It's also the patient's responsibility to know what companies your insurance is in network with. You took the insurance out so I would assume you know what they cover and what they don't cover. I wouldn't have taken Federal Blue Cross without knowing what blood labs they participate in and what doctor's are in network.

@Blingqueen023, I worked for a doctor and always made sure I sent the lab work to the correct lab for the patient's insurance. I would have been in big trouble if I made a mistake.

Re: Who's Responsible

Kachina624 — Tue, 29 Aug 2017 22:41:03 GMT

I wouldn't have given a thought to what lab was going to process my tests, assuming the doctor would send it to one that was approved. Most patients wouldn't have the moxie to know to do that.

My favorite scam to which I fell victim years ago... You go to an approved hospital ER and are seen by a doctor. Later you receive a bill for 100% of the doctors bill because the doctor is employed by an agency, not the hospital. Now how in the world would a patient know that? Why would you ask every hospital employee by whom they're employed? That's just deliberate déception. Non-disclosure. I paid what the insurance allowed and refused to pay more but was hounded for years by a collection agency.

Re: Who's Responsible

deepwaterdotter — Tue, 29 Aug 2017 22:44:14 GMT

My husband and I just chose a new insurance carrier. One of the important determinants was the quality and availability of in-network care providers.

Re: Who's Responsible

I am still oxox — Tue, 29 Aug 2017 22:50:53 GMT

I will always specify where my Labs go, I have been scr**wed" too often

Re: Who's Responsible

I am still oxox — Tue, 29 Aug 2017 23:00:42 GMT

The office will not always share your insurance info.

Here's a good one my hubby was treated at a local ER this June, all the bills except one went to our current insurance,not sure how one went astray and was sent to our prior insurance

Re: Who's Responsible

Blingqueen023 — Tue, 29 Aug 2017 23:03:52 GMT

@Jordan2 wrote:
@Blingqueen023 wrote:
@Jordan2 wrote:
My motto is if it weren't for bad luck I would have no luck at all! It doesn't matter what health insurance I have, something goes wrong. I went to the gynecologist July 25, I had my woman's wellness visit and had a pap smear. Well today I get a bill from Quest Lab for $535.53! The problem is Quest is out of network for my insurance. I called the insurance company and Quest didn't even file a claim with them! Shouldn't the doctor's office know which lab to send the specimen to? Now I have to call the lab and give them my insurance information and have them bill the insurance company, then take it from there.
I work for a doctor and we always check on what insurances different labs takes. It's also the patient's responsibility to know what companies your insurance is in network with. You took the insurance out so I would assume you know what they cover and what they don't cover. I wouldn't have taken Federal Blue Cross without knowing what blood labs they participate in and what doctor's are in network.
@Blingqueen023, I worked for a doctor and always made sure I sent the lab work to the correct lab for the patient's insurance. I would have been in big trouble if I made a mistake.

@Jordan2 Exactly! I have a whole listing in my office of blood labs, x-ray labs, etc with all the insurances listed. Every doctor's office should have that. We get them from the Reps that visit our office. They hand out their prescription pads along with the insurance companies they accept. I still say it's also part of the patient's responsibility to know who takes their insurance and who doesn't.

Re: Who's Responsible

ECBG — Tue, 29 Aug 2017 23:05:38 GMT

@I am still oxox wrote:
The office will not always share your insurance info.
Here's a good one my hubby was treated at a local ER this June, all the bills except one went to our current insurance,not sure how one went astray and was sent to our prior insurance

@I am still oxox,There's no excuse for that one! So sorry.

Re: Who's Responsible

Snoopp — Tue, 29 Aug 2017 23:13:46 GMT

If your doctor is in network the insurance company should have covered a test if it's included in the wellness exam. I'd argue that one with the insurance company.

Re: Who's Responsible

I am still oxox — Tue, 29 Aug 2017 23:21:22 GMT

@ECBG

All it took was a phone call to correct but it was annoying

@ECBG wrote:
@I am still oxox wrote:
The office will not always share your insurance info.
Here's a good one my hubby was treated at a local ER this June, all the bills except one went to our current insurance,not sure how one went astray and was sent to our prior insurance
@I am still oxox,There's no excuse for that one! So sorry.

Re: Who's Responsible

Tribesters — Tue, 29 Aug 2017 23:22:25 GMT

@Jordan2

Same thing happened to me. I argued that I had no control over where the doctor sent the lab work. I went to a participating doctor so services should be covered. As other poster stated they should know which one is in your insurance network. I didn't have to pay the bill so I guess they covered it.

Re: Who's Responsible

nunya — Wed, 30 Aug 2017 10:38:16 GMT

@Moonchilde maybe they did get the results, I called medical records at the hospital, they said they never sent it to the Dr.

As for emergency room Drs, when one sees multiple Drs ....I don't know how anyone would know if every Dr there is "in network". I never received another bill on that one. My insurance would have paid had they not waited over a yr.

Re: Who's Responsible

SilleeMee — Tue, 29 Aug 2017 23:46:46 GMT

Sort of the same thing happened to me where my mammograms where taken in one facility then they were sent out for review by a doctor who was out of my network. This doctor sent me his bill. You bet I had words with my insurance company and after months of repeated phone calls, my insurance company finally paid the bill and told me there was no way I could have known where the mammograms were actually read.

Re: Who's Responsible

blackhole99 — Tue, 29 Aug 2017 23:56:09 GMT

I belong to an HMO and they tell you flat out, if you don't use in network labs, docs, ect. you are on your own. Everything is done in house, so to speak at their hospitals and outside satellite facilities and so far so good. I had their plan before I went on Medicare and then signed up for their supplental insurance and drug program.

Re: Who's Responsible

Jordan2 — Wed, 30 Aug 2017 00:02:34 GMT

@Tribesters wrote:
@Jordan2

Same thing happened to me. I argued that I had no control over where the doctor sent the lab work. I went to a participating doctor so services should be covered. As other poster stated they should know which one is in your insurance network. I didn't have to pay the bill so I guess they covered it.

@Tribesters, my doctor is in network. You would think someone in the office should check your insurance and make sure it goes to the proper lab. On my bill was two mentions of serology. I thought that that has to do with bloodwork, the thing is the doctor didn't draw any blood. There is no way I'm paying this bill, if I owe a copay that's a different story.

Re: Who's Responsible

on the bay — Wed, 30 Aug 2017 00:03:45 GMT

As others have said, it is wise for us to know which lab etc is covered by our insurance but all those times that yes you'd go to the hospital and a radiologist or someone not covered reads something and you are sent a bill-

that to me IS the insurance companies fault!

If they cover a hospital, they should cover everything done there.

Once after several times of getting a random bill, I called the facility and asked who each of their providers, radiologists etc were to make sure they were covered.

And now I think the doctors offices should know too. If they are covered, they better send to a lab that is also covered. Many people would never think there would be a problem with that.

I shouldn't have had to do that.

And I'm so glad to see several of you did not pay those bills but got your insurance company to pay them!

Figuring out multiple people and equipment should not be our jobs.

Re: Who's Responsible

Lapdog — Wed, 30 Aug 2017 00:14:08 GMT

In the exam room at my doctors' they have posted who they use for labs and it is my job to know if they are covered.

In my case United Health only accepts Lab Corp. Not many choices.

Re: Who's Responsible

millieshops — Wed, 30 Aug 2017 00:28:00 GMT

Almost every doctor I use has a sign prominently posted saying patients must knoiw their own insurance. I was just in my primary's office 2 weeks ago - he wanted several different kinds of tests, all of which we had done also at other times. For each, he asked me where I wanted to go and wrote his scripts accodingly.

If I hadn't already known where my insurance was accepted, I would have done research. I did just that last winter when I was using a new doctor in a new neighborhood - first phone call I made to the lab recommended, I learned they would not accept my insurance. Another call to my own company and I had a great experience. It's a pain and not at all a good hospital procedure, but once again my motto - no one cares about my money as much as I do.

Re: Who's Responsible

Moonchilde — Wed, 30 Aug 2017 00:45:20 GMT

@nunya wrote:
I think these things are so common, it's sad.

Just a few...
Had bloodwork done, called the Dr to see if they came back normal, the hospital nor the lab ever sent them results.

Got a bill that was a year old from a Dr who practiced in the ER. The insurance wouldn't pay because they waited a yr and I no longer even had that insurance.

Called the Dr when they sent the wrong script amount to the pharmacy, They said they'd call immediately and fix it. Nope, wrong at next refill.

I'm learning to write everything down, and pay attention because nobody will do it for you.

Just a couple of comments on the first two -

Trust me on this - when a doctor or his office tells you the hospital, or the lab, "never sent" them a copy, it's usually just not true. Doctors' offices have literal stacks of filing they are months behind on. It's standard for them to ignore the filing and call the lab to get a copy faxed right then. They will usually swear to you they didn't get it, but the honest ones and the ones you have a good friendly relationship with will say "help meee! I can't fiiind it! Sorry!" And many times the office fax is malfunctioning (off-line, paper out, etc). So yes, they did get it, they will just always blame the lab because it lets them off the hook.

I can't speak to the waited a year part, but in most departments in a hospital, the physician's professional fees are separate from the hospital's facility and supplies fees. And unfortunately it's up to the patient to check whether the doctor's group takes your insurance. Also, it's very common for a patient to never, ever receive a bill for 6-9 months and suddenly out of the blue get a collection notice. It sucks.