astronomical lab bill

[AZhiker 2,253]

I just got the bill for my 6 month labs - $998.00 !!!!!!! Turns out my BCBS insurance pays for the surgery, but not for any follow up appts, labs, or anything coded for obesity or overweight. I am going to try having my doc resubmit with a coding like "rule out nutritional deficiency" or "rule out malabsorption syndrome." My year labs are coming up in another month, and I sure don't want to get hit with yet another huge bill. Anyone else have this issue with insurance?

[ypease 177]

Amazing! Wow, you would think that since they covered the cost of the surgery, they would pay for aftercare! My insurance doesn’t cover my wls, and my doctor is going to try to run my blood work through their lab. If they charge a fortune, I checked out Any Lab Now. They only charge $449.00 for basically the same tests.

[Lynda486 784]

Oh no! I have BCBS and they would only cover 20,000 total of my surgery. I am waiting for a huge bill to show up and I haven't even had labs done yet! Hope you get this figured out. Can you let me know if running it under a different code helps?

Good luck!

[FluffyChix 17,415]

Oh holy cow!!!!

[Orchids&Dragons 9,047]

11 hours ago, AZhiker said:

not for any follow up appts, labs, or anything coded for obesity or overweight

Sheesh, because they won't be hit with any expenses if you become anemic or malnourished! /snark/

How incredibly short-sighted of them.

[apiane 174]

I don't know if this will help... but I'm having my 6 mo labs drawn at my PCP office along with some tests she wants... I haven't been given any indication that they won't be covered. At least I'll have my FSA money in case it's not. I'm sorry you're going through this. It might be worth calling and appealing. A lot of times you'll get a lower price just for speaking up. It couldn't hurt. Good luck.

[Prestonandme 107]

I ran into this problem twice -- pre-surgery, the surgeon didn't code my labs and tests correctly and I was billed for nearly $1000. He re-coded the labs and tests and my insurance covered it all. Then at six months post, the same thing happened again with my labs. On the day I took them, I called my surgeon's nurse and asked her to add codes to the labs to be sure they're covered by insurance because of what happened last time. She added codes and once again my insurance covered them.

[AZhiker 2,253]

5 hours ago, Prestonandme said:

I ran into this problem twice -- pre-surgery, the surgeon didn't code my labs and tests correctly and I was billed for nearly $1000. He re-coded the labs and tests and my insurance covered it all. Then at six months post, the same thing happened again with my labs. On the day I took them, I called my surgeon's nurse and asked her to add codes to the labs to be sure they're covered by insurance because of what happened last time. She added codes and once again my insurance covered them.

Do you remember how they were coded to get coverage?

[Prestonandme 107]

42 minutes ago, AZhiker said:

Do you remember how they were coded to get coverage?

They used several codes in order to cover all the bases. The original codes were declined because they were considered "not medically necessary" and "not a requisite lab test." So the surgeon's nurse added several codes that showed that my labs and tests were medically required by the surgeon in order to provide me with proper treatment.

[AZhiker 2,253]

11 hours ago, Prestonandme said:

They used several codes in order to cover all the bases. The original codes were declined because they were considered "not medically necessary" and "not a requisite lab test." So the surgeon's nurse added several codes that showed that my labs and tests were medically required by the surgeon in order to provide me with proper treatment.

Thanks. I see the NP tomorrow and will ask her to recode and resubmit. Hopefully that will take care of it. I'm thinking things like "hypercholesterolemia," "malabsorption," "chronic inflammation,""Vitamin D deficiency," "osteopenia" should do it, since I have all of the conditions anyway.