Dr used the wrong lab. HELP!

amother

Purple

Thu, Apr 16 2015, 11:43 am

Went to a doctor in network and they took blood-work. We once had a problem with lab mixup so we informed them to make sure it gets sent to the correct lab. Well it wasnt and we are going be be hit with an almost $4,000 bill. The patient was sick and they ran alot of tests to rule out stuff. We are still dealing with the illness.

My insurance doesnt cover out of network at all. The office could have sent it to a correct lab and we would have had a co-pay.

The doctors office made another mix-up while we were there and gave us a prescription written out to a WRONG NAME. They also told us in a follow-up call that they were in the process of authorizing a procedure with HIPPA, but we dont have HIPPA and we never usually need prior authorization. They do have our insurance on file, I know because I can see that they billed for the visit.

Who is responsible for this mix-up?

I have one more big whooper to add, but I will share it only after I get advice on how to deal with it. My insurance said I can try to file an appeal, but they arent making promises.

amother

Purple

Thu, Apr 16 2015, 11:48 am

abound wrote:

What does the Doctors office say?

There isnt much they can do. They will call the lab and ask if there is a solution.

To me it doesnt sound like much.

Thu, Apr 16 2015, 11:49 am

It's not your problem, and not your fault. Tell the insurance company in very firm language that they should take it up with your doctor's office. And the same for the doctor's office as well as the lab. You did nothing wrong and make it very clear that you're not going to pay the bill.

amother

Purple

Thu, Apr 16 2015, 12:01 pm

I just went on-line and saw that the lab clearly has my insurance listed.

The doctors office called and said the lab claims they take my insurance. NOT MY PROBLEM ANYMORE!

Scrabble123

Thu, Apr 16 2015, 12:44 pm

amother wrote:

I just went on-line and saw that the lab clearly has my insurance listed.

The doctors office called and said the lab claims they take my insurance. NOT MY PROBLEM ANYMORE!

Did you have a deductible? Does the lab have your proper insurance information? Place a call to your insurance company and to the lab to find out what's going on.

Amarante

Thu, Apr 16 2015, 1:10 pm

It looks like the problem has been solved since the lab claims to take this insurance. The end result should be the lab agreeing to take whatever payment insurance would have paid them if they were in network. This is the fairest solution for everyone since neither you nor the doctor are at fault in this situation.

If the lab were really not in the network, I have heard that people can get some success by dealing with the insurance and lab and getting the lab to accept the "in network" compensation.

This drives me SO crazy because you have to be so vigilant about making sure that every test and doctor is in network. I read some terrible stories about people who went to the emergency room and then get hit with a bill because in some hospitals the doctors are not in network even though the hospital is. So these people did everything right because who would think in the midst of a terrible emergency, to see if the doctor in the ER is with your insurance when the hospital is.

nywife

Thu, Apr 16 2015, 2:37 pm

What do you mean "in the process of approving an authorization with HIPPA"? Do you mean HIPAA? It's a privacy law, not an insurance or thing.

This does sound very frustrating. Is this office a small office or a clinic? If it's a clinic I suggest pursuing this matter with the manager or whoevers in charge. Clinics usually have more leeway with retracting mistaken charges.