So last month my pregnant wife did the prenatal genetic screening at her doctor where they take her blood and send it off to a lab to test the unborn baby for any genetic abnormalities. The doctor asked us “will we be doing the genetic screening today?” and we said yes as we thought it was just a routine procedure and that it would be fully covered or mostly covered as a prenatal service under our health insurance plan.
However, today I just received my explanation of benefits (EOB), and it says the provider is charging me $4500 for the procedure and that my insurance didn’t even negotiate the rate down at all. I just don’t understand why insurance didn’t negotiate a lower rate. I know we haven’t met our deductible of $6850, so I know insurance wouldn’t pay for it yet, but for all of my wife’s other doctor appointments in the past, they’d typically negotiate a lower rate. So for example, my explanation of benefits would say something like “provider charged $500, but the allowed charge is $200,” and I’d just have to pay the $200. But this time it says the provider charged $4500, and insurance didn’t negotiate a lower rate at all.
Should I call my insurance to ask why they didn’t negotiate a lower rate? Should I call the provider (the lab) to ask if they will give me a discount if I pay in cash? I haven’t actually received my bill yet so is it possible that the bill will show a lower charge than the EOB?
It’s just annoying because our deductible resets in January. So if we’d known that this wouldn’t have been covered by our insurance, then we would’ve just waited to do the procedure in January so it would count towards next years deductible.
TLDR
Just received an EOB saying I owed $4500 for my pregnant wife’s prenatal genetic screening bloodwork test. Insurance didn’t negotiate a lower rate at all. I haven’t received the bill yet, just the EOB. What should I do next?
submitted by /u/emoney_gotnomoney
[link] [comments]So last month my pregnant wife did the prenatal genetic screening at her doctor where they take her blood and send it off to a lab to test the unborn baby for any genetic abnormalities. The doctor asked us “will we be doing the genetic screening today?” and we said yes as we thought it was just a routine procedure and that it would be fully covered or mostly covered as a prenatal service under our health insurance plan. However, today I just received my explanation of benefits (EOB), and it says the provider is charging me $4500 for the procedure and that my insurance didn’t even negotiate the rate down at all. I just don’t understand why insurance didn’t negotiate a lower rate. I know we haven’t met our deductible of $6850, so I know insurance wouldn’t pay for it yet, but for all of my wife’s other doctor appointments in the past, they’d typically negotiate a lower rate. So for example, my explanation of benefits would say something like “provider charged $500, but the allowed charge is $200,” and I’d just have to pay the $200. But this time it says the provider charged $4500, and insurance didn’t negotiate a lower rate at all. Should I call my insurance to ask why they didn’t negotiate a lower rate? Should I call the provider (the lab) to ask if they will give me a discount if I pay in cash? I haven’t actually received my bill yet so is it possible that the bill will show a lower charge than the EOB? It’s just annoying because our deductible resets in January. So if we’d known that this wouldn’t have been covered by our insurance, then we would’ve just waited to do the procedure in January so it would count towards next years deductible. TLDR Just received an EOB saying I owed $4500 for my pregnant wife’s prenatal genetic screening bloodwork test. Insurance didn’t negotiate a lower rate at all. I haven’t received the bill yet, just the EOB. What should I do next? submitted by /u/emoney_gotnomoney [link] [comments]Read Morer/HealthInsurance