Hi folks,
I’m going to preface everything here by saying I’m extremely ignorant to all things insurance as I’m just recently on my own plan separate from my parents and haven’t been to the doctor’s in a number of years.
At the time of the visits/work I’ll discuss below, I had BCBS. As of May 1, my employer has switched to Harvard Pilgrim, but all of the visits and tests were done under BCBS. I live in Massachusetts.
I saw a new PCP for the first time in mid March of 2021 to try and get diagnosis for some ailments. My doctor order about 7 blood tests for various things. I had an appointment with a specialist and follow-up appointment with my PCP in late March, during which they both ordered additional blood tests, somewhere around 25 between the two doctors. So, total for both blood work sessions would be 30-35 tests.
Both doctors are in/affiliated with a Medical Group/Hospital and the bloodwork was done in the hospital as they ordered. Everyone assured me it was in network, and based on the overview from my insurance, it seems that’s correct. I received a call from the hospital/medical group some weeks later advising me that I owed around $1,900 for the bloodwork. However, if I look at the “Amount You Owe” section from the two dates on my insurance portal, it says I owe around $1050.
As an aside, I never received any invoice and this type of billing, as I’ve been informed by some different billing department staff members I’ve talked to, doesn’t show up in the online portal billing section. Frustrating that I never would have known about this had I not received a call telling me I was delinquent in payment. They do have all my correct info on file, so I’m not sure what’s going on there.
So, with all of this, I have a couple questions:
1) Does the amount that I’m being charged (either $1050 or $1900) seem correct for the work my doctors have ordered?
2) Who is right in this situation for the payment: my insurance or the hospital?
3) I’ve seen other folks mention coding when it comes to bloodwork – is it possible this would apply to my case and that I’ve been charged incorrectly?
Bottom line is $1900 (or $1050, for that matter) is a lot of money and if I can reduce that amount, I’d love to. I also do not want to risk this going to collections or making a bad mark on my credit or something of the like, so I’m trying to get this sorted out quickly.
Also, only loosely related: I had paid my deductible for BCBS before my employer switched to my new insurance provider. I’m assuming I have to start again at $0 for the new deductible, but wondering if there’s any weird workaround to transfer deductible credit or something to my new provider? I know that’s a shot in the dark and very likely a dumb question, but I figured I’d ask anyway.
Apologies for the novel of a post, I’m just starting to mildly panic and want to get this all sorted. If I can provide any other helpful information, please let me know.
Thank you for any help you might have.
submitted by /u/Empty-Motor
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Hi folks, I’m going to preface everything here by saying I’m extremely ignorant to all things insurance as I’m just recently on my own plan separate from my parents and haven’t been to the doctor’s in a number of years. At the time of the visits/work I’ll discuss below, I had BCBS. As of May 1, my employer has switched to Harvard Pilgrim, but all of the visits and tests were done under BCBS. I live in Massachusetts. I saw a new PCP for the first time in mid March of 2021 to try and get diagnosis for some ailments. My doctor order about 7 blood tests for various things. I had an appointment with a specialist and follow-up appointment with my PCP in late March, during which they both ordered additional blood tests, somewhere around 25 between the two doctors. So, total for both blood work sessions would be 30-35 tests. Both doctors are in/affiliated with a Medical Group/Hospital and the bloodwork was done in the hospital as they ordered. Everyone assured me it was in network, and based on the overview from my insurance, it seems that’s correct. I received a call from the hospital/medical group some weeks later advising me that I owed around $1,900 for the bloodwork. However, if I look at the “Amount You Owe” section from the two dates on my insurance portal, it says I owe around $1050. As an aside, I never received any invoice and this type of billing, as I’ve been informed by some different billing department staff members I’ve talked to, doesn’t show up in the online portal billing section. Frustrating that I never would have known about this had I not received a call telling me I was delinquent in payment. They do have all my correct info on file, so I’m not sure what’s going on there. So, with all of this, I have a couple questions: 1) Does the amount that I’m being charged (either $1050 or $1900) seem correct for the work my doctors have ordered? 2) Who is right in this situation for the payment: my insurance or the hospital? 3) I’ve seen other folks mention coding when it comes to bloodwork – is it possible this would apply to my case and that I’ve been charged incorrectly? Bottom line is $1900 (or $1050, for that matter) is a lot of money and if I can reduce that amount, I’d love to. I also do not want to risk this going to collections or making a bad mark on my credit or something of the like, so I’m trying to get this sorted out quickly. Also, only loosely related: I had paid my deductible for BCBS before my employer switched to my new insurance provider. I’m assuming I have to start again at $0 for the new deductible, but wondering if there’s any weird workaround to transfer deductible credit or something to my new provider? I know that’s a shot in the dark and very likely a dumb question, but I figured I’d ask anyway. Apologies for the novel of a post, I’m just starting to mildly panic and want to get this all sorted. If I can provide any other helpful information, please let me know. Thank you for any help you might have.
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