Surprise doctor's bill?

Question

So far, my OB-GYN has been covered by my insurance deductible. I just got a bill in the mail for some routine labs that were drawn. We've been paying monthly payments to the doctor every month (working toward paying off the deductible). I was not informed that the labs would not be covered in my monthly payments; if I had been, I wouldn't have had them drawn. Do I have a right to not pay this, since I was not informed that I would be billed?

Answer 1

Lab work is almost always billed separately from the doctors visits. The laboratory does not care what agreement you have with your OB/GYN, so if you don't pay the bill they will just send it to collections.

I would be very careful with the payments to the OB/GYN too. My wife's also estimated what we would owe based on out deductible, etc, but not considering how the separately billed blood tests, ultrasound, etc, would eat into the deductible as well. Well, we ended up overpaying by $400 and it took us four months to get our freaking money back from them.

Answer 2

You should know that whatever services you receive will be sent to your insurance (that will then be applied towards your deductible). Contact the lab and make a similar arrangement now, so that you will be afforded (possibly) a longer timeframe to pay them in full. Please don't refuse any treatment your doctor deems reasonable for the health of you and your baby. It's not worth it!

Answer 3

No.

You should expect that when you have a service performed, you should be charged for it.

Answer 4

1) it is your responsibility to know the benefits of your health plan

2) if this is for pregnancy, generally your labs should not be subject to the deductible

3) call your insurance company to inquire if the claim was processed correctly, as it could be a mistake.

Answer 5

You need to ask your doctor's office if their prenatal fee includes the lab work.  When I was pregnant years ago, it was all covered under the doctors fee.  If that is the case, you should not be billed.  However, if not, you will be billed for lab work, and any other testing that may occur, including fees for the testing facility and the professional component.  So you do not have the "right" not to pay.  Just because you are not informed you will get a bill, does not mean you are not liable to pay, you are.

Answer 6

No.  They can't tell you before every move they make if your insurance will or will not cover it.  They can't possibly uderstand everything that every insurance company will cover and at what rate.