I thought this would be a good contribution given the 30-day challenge. I’m pregnant and had to get some testing done, which my provider outsourced to other labs. She gave me the options, and I called ahead to determine which would cost less with my insurance. I was quoted $300, and went with that. Imagine our surprise a couple of months later when we get a bill for $1600. I called and negotiated it down 20%, and then finally down to the original $300 quote. Just a reminder to those with medical bills that they aren’t set in stone, and all it takes is a phone call to find out what the billing provider and/or your insurance can do for you.
Full disclosure: I work in the health care industry in a non-clinical capacity. So behind the scenes, with outsourced tests and lab work, companies essentially lobby doctors to use their services and products, just like pharmaceutical companies. Because this test is pretty specific it isn’t done by Qwest or other labs that process basic diagnostic lab work and there are fewer labs that do it, so options are limited. My provider chooses to work with three labs that offer this test, and will do the blood work in house then send it off to one of those three companies. She gave me the info for all three companies, and I researched each by calling and giving them my specific insurance info and asking for a cost estimate if I used their company for the test, and asking what all their version of this blood panel screened for. Your provider should have brochures and info for all the products and services that are offered that he/she doesn’t directly provide. If it’s basic diagnostic lab work, like blood glucose tests for example, they are probably just going to use a lab near their office (and there is probably at least a couple of options depending on the size of your town or city). If you’re receiving big bills, I’d talk to your provider about your lab work options. I’d start by asking which are absolutely necessary and which can maybe be done at longer intervals (assuming they’re recurring tests), or not at all. Then I’d ask what labs he/she works with and request their contact information. Each lab is going to have a billing department, and should have a team that can work on prior authorization for insurance. You call and give them your specific insurance info, the insurance company, plan, and group number, and they can give you a cost estimate. When you do this make sure to ask if that cost estimate is based upon whether or not you’ve met your deductible because that will make a difference. Take notes, get the name of the rep providing you this information, and write down the date you call.
If you’re calling to negotiate a bill, you’ll call the billing provider, which in my case was the lab. I let the rep know that I had called previously (and they had knowledge of this, so I guess they’d entered my info in their system) and told him what the other rep had told me. We went back and forth for a bit, and he was truly nice and helpful, and after a few instances of putting me on hold to speak with a manager, he confirmed that they would honor the amount I was originally quoted. If they hadn’t, then I was planning on calling my insurance provider. At the very least, I was going to get them to put me on a payment plan, and request a monthly statement, and take their 20% discount they offered. Hope this info helps! Talk to your doc though; they are used to dealing with billing issues and can help you figure out the best way to receive the care you need for the least amount of cost out of your pocket.
TLDR: Talk to your doc about your testing options, including which tests are absolutely necessary, and request contact info for the labs they use. Contact those labs with your insurance information and find out what the bill would be for your tests, including before and after deductible. Take notes. To negotiate a bill, call billing provider and discuss whether or not you were quoted something different, and what your options are for reducing payment.
They actually did say they had financial assistance, which I declined because I knew we probably wouldn’t qualify. They just said they were going to honor the original quote.