"FREE" annual medical preventative checkup costed me > $300 - am I responsible?

  • by Curious
  • Dec 31,2018
  • 11 answers

My medical insurance pays for an annual preventative checkup so every year so I schedule that with my doctor with that understanding that it is covered at 100 percent.
The previous 2 years I didn t have to pay anything but this year, without telling me beforehand, my doctor s office sent my bloodwork to a different laboratory which is "out of network" so insurance wouldn t cover it and I got a $300+ bill from the laboratory.
Had I known my doctors office didn t first verify the new lab was in network, I would not have had the bloodwork done. Do I have any recourse to avoid having to pay this or have the doctor s office be held accountable for not checking or notifying me?


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Insurance Answers (11)

Flower 2 weeks ago

What does the doctor's billing department have to say about doing that? We have to know their position before advising you how to proceed. You might try asking the insurer if they will cover it because you did not authorize a non-network lab. What does your insurer say?

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Beverly S 2 weeks ago

Nope.. this happens EVERY day! Same happened to me in April. It is our responsibility to check.. I learned the hard way... I ask now when I schedule an appointment. Sorry this happened to you!

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Pascal the Gambler 2 weeks ago

They send blood work where they send it. Might argue it with them, but probably will get nowhere.

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Maxi 2 weeks ago

It is your insurance and you are responsible to inform the dr of the network which your insurance covers.........

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David George Uk 2 weeks ago

Your doctor sounds responsible so I would send the bill to them. Now I am British and all this is covered by our wonderful National Health Service (NHS) I have known all my 74 years. Why dont you demand the same ?

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lucy 2 weeks ago

Sorry, but it is YOUR job to verify if a provider/lab is in network or not. Every year, your insurance and your doctor can be in network or out of network, depending if they agree on the contract that can change.
Odds are that your doctor and the patients they have can have up to 100 or (more) insurance companies/plans they work with.
Now with the new healthcare law, the free preventive exam usually does (not) include lab/blood test or other tests. Over the years I had to pay for my blood tests. But, each company can be different on what they cover/pay. About 5 years ago, I got hit with a $400 bill for blood tests that my insurance would not cover, thus the (next) time I told my doctor, who then sent me to the hospital that I paid $60 cash for the same tests.
So, if your doctor always takes the blood tests, then (before) your next exam you call the doctors office and ask them (what) company do they use, then you verify with your own insurance if they cover or not.

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Insurance Pickle.com 2 weeks ago

I wouldn't pay it. I'd call the doctor's office to get it straightened out. As the patient, it can't be expected that you're going to quiz the doctor on where they're going to send it. I had the same thing happen to me once and the lab ended up eating it.
It's your job to get it squared away, so don't ignore it. But, start with the office that sent it to the wrong place.

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Foofa 2 weeks ago

Contact the doctor and the lab. You can probably negotiate this figure down.

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Nosehair 2 weeks ago

By using the same office for two years there is a pattern established and this practice could easily be used to direct lab work to a specific lab that is commercially beneficial to the dr's office. The dr's office should absorb the cost of this error the same way any other business would be expected to correct their error. I would take it to small claims court but must admit, I'm not sure of the probable outcome. Threatening to find another doctor and write negative Yelp reviews might be more affective in encouraging some cooperation...?

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Casey Y 2 weeks ago

While it is technically your job to verify...yada yada yada...you should be able to fight this with your doctors office and get the dollar amount reduced...

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Judy 2 weeks ago

Yes unfortunately you are responsible, ut I'd contact the doctor and let him or her know of the error, and see if it can be redduced substantially.

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