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Category: Prenatal Testing

Asked by nesssicle

Q: unauthorized tests

Imagine my surprise today when i get an Explanation of Benefits letter from my insurance company stating im going to potentially owe 3g's for "routine lab services". I called my insurance carrier and was told that they just have to send this out if the Dr's office submitted it to them. She couldn't exactly tell me what they were for (the explanations she had were so medically vague that there is no way to know what they were). I looked up the provider information and it was for a lab that does genetic testing. I NEVER AUTHORIZED MY DR TO DO ANY GENETIC TESTING ON ME. I told him i didn't want any from the very beginning and every time he offered it to me i told him NO. To make matters worse, they sent the material to an out of network lab, rendering my insurance pretty much useless.

MY question is: Should i request a copy of my medical records before confronting my Dr's office?

Im definitely fighting this, because there is no way im paying for something i didn't even wa

This question was asked Feb. 27, 2013 6:25pm
Category: Prenatal Testing

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Answers (5)

Answered by 12danes - Oct. 2, 2013 3:14pm

First, wish all is going well, Second, if u don't mind me asking... what end up happening with this issue, I just received the bill from my wife first prenatal appointment, $1400 after insurance pay the bulk of it, i believe they added genetic test at the cost of $3700 with out her consent, I'm furious, ready to call attorney general.
Thanks

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Answered by nesssicle - Feb. 28, 2013 7:30pm

I just got back from my appt not too long ago, and they told me not to worry about this, it shouldn't end up costing me more than $25....Well, if this ends up being the case i guess ill just pay it even though i never wanted the test. I probably should have waited until i received a bill before i started going crazy about it, but i couldn't help it! A lady at the office told me she would be calling the lab today and try to figure out what happened, and that she would call me as soon as she found out more.

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Answered by nesssicle - Feb. 27, 2013 7:31pm

Thank you. Its so hard to keep calm in these types of situations. Im really trying and i know if i just get angry right of the bat with them, its going to get me nowhere!

I called the insurance carrier and they couldn't tell me much, the . I called the Dr's office and was told that all those blood tests were routine. Well, if they were so routine wouldn't they be covered, and why were they submitted to two different labs; one in network and one out of network? She said they'd look into everything and have more answers for me at my appointment tomorrow. I have this inkling it was for a cystic fibrosis screening test which i told them 3X'S that day that i didn't want.

I really hope this is a mistake, i really like my Dr but if this doesn't get resolved i will certainly be switching Dr's!

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Answered by janastep73 - Feb. 27, 2013 7:26pm

I would talk to your doctor's office...when you refused the genetic testing, did you sign anything saying you didn't want it done? Otherwise it might be your doctor's office's word against yours and that may be hard to prove. I would definitely contact your doctor's office to see if you could get a detailed explanation of what tests were billed, since the document you have now is pretty vague and get a copy of your medical records to see if you signed anything saying you didn't want those tests or if the doctor notated in your chart.

Since your insurance company didn't cover it since it was out of network, if you were found to be in fact responsible for the charges, you would owe the doctor's office for this. But since you didn't authorize these tests, I would say that the doctor's office might just have to eat the costs....they shouldn't have done them in the first place if you refused them!!!

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Answered by stephpan - Feb. 27, 2013 7:17pm

I'd request a copy of your medical records and call your insurance back and ask for detailed information about the charges. I'd also ask your doctor's office about the bill when you ask for your medical records and explain the situation. They might be able to explain what the labwork was for and if it isn't in your record they can fix it for you. It may be a coding error from your doctors office. Insurance related stuff is awful to try and fix - I wish you a lot of luck in getting it sorted out. The only thing I can say for advice is not to take No or I don't know or unclear information for an answer. Keep pushing and ask for the next person up the chain.

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