Hey All,
I went to my doctor for a routine checkup back in January. He referred me for blood work at a local Quest lab and told me it was in-network, and when I asked the lab tech whether my insurance was in-network, she also said yes. I received no invoices other than my check up bill from the doctor in February.
Flash forward 6 months and out of the blue I get an explanation of benefits from my insurance company saying that the blood work was invoiced for $700 out of network with no coverage at all. I haven't actually received the bill yet but I imagine it will be arriving shortly.
I asked my doctor for a written prescription so I could find a place to go on my own, but he insisted that I go to this particular lab and that it was in-network for me. He said it was against their policy to offer traditional prescriptions any longer. Even if I needed a penicillin prescription, they wouldn't give me a plain slip - they only call in prescriptions.
I called the doctor's office and told them what happened. They told me to call them back and fax the bill once I receive it. But I'm still thinking about what my next escalation point will be to get as much as possible of this bill written off. Here are some of the options I've thought of:
1) Make an appeal directly to the doctor/doctor's office. Swear to never come back if they can't cover most of it (though honestly, I probably won't go back anyway)
2) Make an appeal to Quest. I've found some accounts of people being successful taking this path but it seems like a long shot.
3)Make a claim appeal with the insurance. An in-network doctor refused to give me the tools I needed to manage my own healthcare costs after all (ie, refusing to give a written prescription to use at any lab and coercion to visit the lab he preferred)
Now I know to never, ever go anywhere or do anything new related to my health without calling my insurance first. And to repeat the process every year before appointments with doctors I've already visited. What a crappy reminder!