So I live in NYS and I have a PA based blue cross plan. Apparently sometime in 2021, the PA based BCBS plan has changed their billing scheme for LabCorp in that if you go to LabCorp, the lab has to send the claims to the patient’s local BCBS. I had a bunch of lab work done late last year (well after I hit my deductible and these were all garden variety standard tests that should have been $0 out of pocket). LabCorp is listed as being in network with my main Blue Cross plan-and still is. One set had to be at LabCorp because the hospital had test tube shortage and they needed me to go out to have the lab work done. Since LabCorp is listed as in network, I went there. The other, was physically drawn at an in network hospital, but all of it was sent to a LabCorp. It’s been a few months and I haven’t seen any claims, so after a bunch of calls between LabCorp and my PA based BCBS plan, I learn that MY local BCBS plan in NY based on where I live, does not have LabCorp as a par provider! If I lived in NYC, it would have been billed to a different local BCBS that does have LabCorp in network, but based on my physical location in the state, my local plan apparently does not have them in network. So I get billed for out of network and on the hook for nearly 1K in basic blood work. Yet my actual plan, has LabCorp listed as in network.
What recourse do I have? Even the people in the PA BCBS plan are bewildered but totally useless. How is it that someone with this PA based BCBS plan who lives in NYC can get their LabCorp bills paid, but someone who lives elsewhere with a different local BCBS plan does not? I demanded that the issue get escalated to contracting/credentialing and to the rep’s supervisor and manager, and apparently it will but my gut says nothing will come of this.
submitted by /u/SJP8
[link] [comments]So I live in NYS and I have a PA based blue cross plan. Apparently sometime in 2021, the PA based BCBS plan has changed their billing scheme for LabCorp in that if you go to LabCorp, the lab has to send the claims to the patient’s local BCBS. I had a bunch of lab work done late last year (well after I hit my deductible and these were all garden variety standard tests that should have been $0 out of pocket). LabCorp is listed as being in network with my main Blue Cross plan-and still is. One set had to be at LabCorp because the hospital had test tube shortage and they needed me to go out to have the lab work done. Since LabCorp is listed as in network, I went there. The other, was physically drawn at an in network hospital, but all of it was sent to a LabCorp. It’s been a few months and I haven’t seen any claims, so after a bunch of calls between LabCorp and my PA based BCBS plan, I learn that MY local BCBS plan in NY based on where I live, does not have LabCorp as a par provider! If I lived in NYC, it would have been billed to a different local BCBS that does have LabCorp in network, but based on my physical location in the state, my local plan apparently does not have them in network. So I get billed for out of network and on the hook for nearly 1K in basic blood work. Yet my actual plan, has LabCorp listed as in network. What recourse do I have? Even the people in the PA BCBS plan are bewildered but totally useless. How is it that someone with this PA based BCBS plan who lives in NYC can get their LabCorp bills paid, but someone who lives elsewhere with a different local BCBS plan does not? I demanded that the issue get escalated to contracting/credentialing and to the rep’s supervisor and manager, and apparently it will but my gut says nothing will come of this. submitted by /u/SJP8 [link] [comments]Read Morer/HealthInsurance