Insurance Question

[Don]

Just seeing if you guys might have some insight on this...

Went to the doctor for the first time in several years last month mainly because I haven't seen one in several years, am in fact getting older, and I wanted to establish a PCP. Go through the motions, everything is fine, etc... Doctor asks how long it's been since I've had an STD test. It's been awhile. He gives me a slip of paper, tells me to go down the hall to get blood drawn, so I do. Everything came back good. No worries.

Got a bill today saying my insurance covered roughly $200 of a $700 bill, and I owe $500 for the test. Looked at my benefits guide, which said preventative STD screenings are covered at 100%. So, um, what does this all mean? Will my insurance cover the rest but they just haven't gotten around to it?

[IEAngelsfan]

Check your policy to see if you have a deductible. If so, it's probably $500

[Don]

Definitely have a deductible (and it's much higher than $500). It's just that these are considered preventative services and are supposed to be covered regardless of deductible.

[fan_since79]

I sometimes get EOB's, or Explanation of Benefits which seem to indicate that I owe money for a covered service, but they are not bills. My colonoscopy was fully covered under preventative care, and the EOB they sent had all sorts of columns and numbers. I filed it away. If your policy says your test is covered, then they should not be charging you. Are you sure what you received was an actual bill and not one of these EOB's?

[Don]

17 minutes ago, fan_since79 said:

I sometimes get EOB's, or Explanation of Benefits which seem to indicate that I owe money for a covered service, but they are not bills. My colonoscopy was fully covered under preventative care, and the EOB they sent had all sorts of columns and numbers. I filed it away. If your policy says your test is covered, then they should not be charging you. Are you sure what you received was an actual bill and not one of these EOB's?

I think it was a bill. It came from the hospital (online system) and clearly displayed the amount my insurance had covered. Need to talk to both the hospital and insurance company (BCBS) on Monday. I just hate having crap like this hanging over my head, and hate having to step away from work to deal with it.

[Brandon]

depending on the insurance you can just call them up and get it squared away pretty easily.

it's possible the hospital coded it incorrectly, so the insurance company followed suit with the code they were given.

usually doctors/hospitals are good about doing to extract as much as possible from insurance while keeping it relatively less out of pocket for the consumer. 

[Don]

13 minutes ago, Brandon said:

depending on the insurance you can just call them up and get it squared away pretty easily.

it's possible the hospital coded it incorrectly, so the insurance company followed suit with the code they were given.

usually doctors/hospitals are good about doing to extract as much as possible from insurance while keeping it relatively less out of pocket for the consumer. 

We'll see I suppose. I'm hoping it's just an odd billing issue that can be resolved easily. Otherwise, $500+ for a simple STD test seems absurd and probably not good for public health overall.

[Tank]

1-800-CALSCUF

make the call, Don.

[IEAngelsfan]

1 hour ago, calscuf said:

You're very photogenic Cals.

[IEAngelsfan]

As someone mentioned, call your insurance company to see if the procedure is covered. If so, they should get that resolved with the lab.

[wopphil]

5 hours ago, calscuf said:

Someone sent a firm-wide email the other day asking for recommendations for a good WC attorney. I thought of you, but then thought "nah, summer is approaching, he has an 18-week vacation coming up."