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Bill from lab

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simmer2

Junior Member
What is the name of your state (only U.S. law)? California

Last year I had a colonoscopy, authorised by my EPO insurance provider, including lab tests. I received a bill from the lab to say the insurance covered most of the tests but not one biopsy so they're billing me for it. I phoned them up and told them the situation and they said to call my insurance as it was probably a mistake. This I did and thought nothing more of it until I got another bill from the lab. So I wrote to the lab saying they should deal with my insurer - after all, this specimen was taken from my body as a routine test for that procedure while I was legally unfit to give approval (anesthetic) which, as I understand it, is down to the doctor.

Since sending that letter I've now received two more bills from the lab, the latest a "final notice". There has been no acknowledgement or reply to my letter.

The last time I got billed falsely (long story, basically bait and switch on me with the doctors, so the doctor that I checked in for, signed my name on his check-in sheet, but saw somebody else who wasn't covered) it took 18 months, about as many letters, numerous phone calls, and hours and hours of wasted time trying to sort out. Eventually they quietly dropped it without responding to a single letter that I'd sent by signed delivery. Not one. I only heard from the debt collection agency, who were decent enough to let me know, that they'd dropped all bills. So basically I want to avoid this scenario all over again with my insurance company.

Any advice on how to put an end to this nonsense ASAP would be appreciated. Thanks.
 


Zigner

Senior Member, Non-Attorney
What is the name of your state (only U.S. law)? California

Last year I had a colonoscopy, authorised by my EPO insurance provider, including lab tests. I received a bill from the lab to say the insurance covered most of the tests but not one biopsy so they're billing me for it. I phoned them up and told them the situation and they said to call my insurance as it was probably a mistake. This I did and thought nothing more of it until I got another bill from the lab. So I wrote to the lab saying they should deal with my insurer - after all, this specimen was taken from my body as a routine test for that procedure while I was legally unfit to give approval (anesthetic) which, as I understand it, is down to the doctor.

Since sending that letter I've now received two more bills from the lab, the latest a "final notice". There has been no acknowledgement or reply to my letter.

The last time I got billed falsely (long story, basically bait and switch on me with the doctors, so the doctor that I checked in for, signed my name on his check-in sheet, but saw somebody else who wasn't covered) it took 18 months, about as many letters, numerous phone calls, and hours and hours of wasted time trying to sort out. Eventually they quietly dropped it without responding to a single letter that I'd sent by signed delivery. Not one. I only heard from the debt collection agency, who were decent enough to let me know, that they'd dropped all bills. So basically I want to avoid this scenario all over again with my insurance company.

Any advice on how to put an end to this nonsense ASAP would be appreciated. Thanks.
Call your insurance company again.
 

simmer2

Junior Member
Call your insurance company again.
The point being: how many more times when, firstly I already did that, and secondly the last time I tried to sort out false billing with them it took 18 months, numerous letters, and phone calls. Why should I be the one paying with time and money to sort out something which - as far as I know - is not my problem?
 

NIV

Member
The point being: how many more times when, firstly I already did that, and secondly the last time I tried to sort out false billing with them it took 18 months, numerous letters, and phone calls. Why should I be the one paying with time and money to sort out something which - as far as I know - is not my problem?
Of course it is your problem. You are the one who received the service and you are the one who owes the amount. The fact you have insurance that covers it (Or, might cover it.), is an entirely separate matter.

If you ignore the issue, it will be properly reported on your credit and the lab may seek payment through any legal means. I would prefer the insurance company pay for it. Your job is to convince them to pay it. It is NOT the job of the lab or doctor to convince them.
 

simmer2

Junior Member
Of course it is your problem. You are the one who received the service and you are the one who owes the amount. The fact you have insurance that covers it (Or, might cover it.), is an entirely separate matter.

If you ignore the issue, it will be properly reported on your credit and the lab may seek payment through any legal means. I would prefer the insurance company pay for it. Your job is to convince them to pay it. It is NOT the job of the lab or doctor to convince them.
I was led to believe elsewhere that it is the doctor's responsibility because I was unable to give authorisation. Maybe that was wrong. So anybody want to place bets on how much time and money it will cost me to get the insurance company to pay...? (remember, last time was 18 months)
 

NIV

Member
I was led to believe elsewhere that it is the doctor's responsibility because I was unable to give authorisation. Maybe that was wrong. So anybody want to place bets on how much time and money it will cost me to get the insurance company to pay...? (remember, last time was 18 months)
The doctor is not responsible in any way. If you were found unconscious on the street and a doctor took you to the hospital for treatment, EVEN WITHOUT ANY AGREEMENT FROM YOU, you would be responsible for any medically necessary procedures. In this case, you have the additional problem that you probably agreed to any additional procedures in either your admission documents or informed consent.

editeditedit

Did you get an EOB on the biopsy? If not, I'd contact the doctor/lab to make sure they submitted the claim "as a service to you". If not, encourage them. If they don't, pay it and submit the claim under your policy's procedure. If you did get an EOB denying the charge, appeal it.
 
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ecmst12

Senior Member
Did you send the bill to your insurance company? Did they process the claim? If not, send it to them. Or, CALL the provider and make sure they have your insurance information to send the bill to the right place. If not, give it to them.
 

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