Out of Network Lab Work Can Cost a Fortune
I went to the doctor and everything went pretty well. The checkup probably lasted 15-20 minutes total and that included having some blood drawn. I paid my $25 copay for services and thought that would be the end of it. You can imagine my surprise when almost 5 months later (February 2011) I get a bill from Quest Diagnostics for $93.38 for the lab work that was done during the September visit.
When I first received the bill I went back and looked at my "Benefits and Coverage" information on the United Healthcare website. It stated that all lab work should be covered at 100% after the initial copay. The next place I looked was my "Explanation of Benefits." When I got to my "Explanation of Benefits" I found my answer. Here it was: " This physician or health care provider is not a network provider but has accepted a discount on this service in accordance with his or her multiplan agreement."
Quest Diagnostics was not an in network lab provider. The doctors office I had used sent all of my lab work to an out of network provider. The amount charged was $200.88 but thankfully Quest only charged me $93.38. I still was not very happy about this.
I called United Healthcare and they told me that this was not their issue. I was advised to take it up with the doctors office. The doctors office is currently in the process of getting back with me. I am not holding my breath on getting back my $93.38
The moral of the story is make certain that your doctor sends all of your lab work to an in network lab. From now on I will ask the doctor about this before any lab work is done. $93.38 is not a ton of money but imagine if this amount would have been $500 or $2000. That is a lot of money for almost anyone.
Published by Jacob Horn
Bachelor of Arts in History and M.Ed. from Freed-Hardeman University. Interned in Washington D.C. under U.S. Congressman Marion Berry. Served as Team Leader for the Tennessee Youth Conservation Corp at Pic... View profile
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