I had a blood test performed that measures medication levels in my blood and if I’m developing any antibodies for it. This is a specialized test that only one laboratory can do.
Not many places in town will draw blood for it and ship it off to the lab. But my doctor’s office found one of the hospitals in town will.
So on July 8th I took my paperwork to get it drawn. The staff there had no idea how to put it in the system or how to store the blood sample. They made several calls and figured something out and took my blood.
My doctor’s office got the results about a week later. I assumed I would receive a bill from the lab since other specialized laboratories have billed us directly. Nothing came.
Fast forward to today I get a bill from the hospital for $1500. It was originally $3500 before the negotiated discount with UHC. I called the hospital and asked for an itemized bill. The lady informed me it only said “misc lab work” and probably wouldn’t help me. I said nevermind on that then.
I called the lab that did the test. They have a financial assistance program for the test and wanted some info. Negative on that since they billed the hospital directly, not me.
I then found out this may be called pass-through billing. UHC prohibits and says do not bill members for such things.
I called UHC and the guy pulled up the article and said it sounds like what’s going on. He said it was submitted as if they did the lab work. Tomorrow UHC is going to have a call with me and we’ll call the hospital billing dept.
Ideally I want the lab to bill me so I can work out lowering the payment.
I’m hoping someone may have information on this or any tips to navigate the waters.
Here’s a link to that article https://www.uhcprovider.com/en/admin-guides/administrative-guides-manuals-2021/ch10-our-claims-process-2021/pass-bill-clia-reqreimb-pol-ch10-guide.html
submitted by /u/gloriousbstrd
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I had a blood test performed that measures medication levels in my blood and if I’m developing any antibodies for it. This is a specialized test that only one laboratory can do. Not many places in town will draw blood for it and ship it off to the lab. But my doctor’s office found one of the hospitals in town will. So on July 8th I took my paperwork to get it drawn. The staff there had no idea how to put it in the system or how to store the blood sample. They made several calls and figured something out and took my blood. My doctor’s office got the results about a week later. I assumed I would receive a bill from the lab since other specialized laboratories have billed us directly. Nothing came. Fast forward to today I get a bill from the hospital for $1500. It was originally $3500 before the negotiated discount with UHC. I called the hospital and asked for an itemized bill. The lady informed me it only said “misc lab work” and probably wouldn’t help me. I said nevermind on that then. I called the lab that did the test. They have a financial assistance program for the test and wanted some info. Negative on that since they billed the hospital directly, not me. I then found out this may be called pass-through billing. UHC prohibits and says do not bill members for such things. I called UHC and the guy pulled up the article and said it sounds like what’s going on. He said it was submitted as if they did the lab work. Tomorrow UHC is going to have a call with me and we’ll call the hospital billing dept. Ideally I want the lab to bill me so I can work out lowering the payment. I’m hoping someone may have information on this or any tips to navigate the waters. Here’s a link to that article https://www.uhcprovider.com/en/admin-guides/administrative-guides-manuals-2021/ch10-our-claims-process-2021/pass-bill-clia-reqreimb-pol-ch10-guide.html
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