Tissue sample sent to an out-of-network lab

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My husband was scheduled for a colonoscopy. A few weeks prior to the procedure, he checked with our insurance carrier (Anthem BCBS) to make sure the facility, the GI doctor, and the anesthesiologist were considered in-network. He was told they were all considered in-network. The procedure takes place and we get an EOB showing that the facility, GI doc, and anesthesiologist were covered at the in-network rate. All’s good so far. Some time later, we get a bill from a lab for processing of the biopsy samples that were taken during the colonoscopy. This was a surprise. Apparently, the lab is not in-network and as a result we owe quite a bit of money to the lab.

It didn’t occur to my husband to ask his GI doc for the name of the lab used for tissue sample evaluations, to then check whether the lab was in-network. He assumed that as long as facility and all docs were in-network, everything else would be too. In the future, should the status of labs used for blood or tissue samples, as in-network or not, be something we add to the list of things we check prior to procedures?

submitted by /u/Janezo
[link] [comments]
My husband was scheduled for a colonoscopy. A few weeks prior to the procedure, he checked with our insurance carrier (Anthem BCBS) to make sure the facility, the GI doctor, and the anesthesiologist were considered in-network. He was told they were all considered in-network. The procedure takes place and we get an EOB showing that the facility, GI doc, and anesthesiologist were covered at the in-network rate. All’s good so far. Some time later, we get a bill from a lab for processing of the biopsy samples that were taken during the colonoscopy. This was a surprise. Apparently, the lab is not in-network and as a result we owe quite a bit of money to the lab. It didn’t occur to my husband to ask his GI doc for the name of the lab used for tissue sample evaluations, to then check whether the lab was in-network. He assumed that as long as facility and all docs were in-network, everything else would be too. In the future, should the status of labs used for blood or tissue samples, as in-network or not, be something we add to the list of things we check prior to procedures?
submitted by /u/Janezo [link] [comments]Read Morer/HealthInsurance

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