insurance vent- need advice

just got bill from lab for $1600 for some genetic prenatal testing. said insurance company denied pending more information. now what? am i resposible t opay while it gets sorted out? this was done when I was 6 weeks pregnant, now i'm 20 weeks.
fwiw, I have Empire BCBS. I had it when I was pregnant with #1, 2 years ago- and had no issues. didnt pay a cent. now, also have BCBS PPO, different employer though, but havign muliple issues- mostly with lab stuff. grr.

Re: insurance vent- need advice

Honestly, i would call up your insurance provider. Usually you can tell them them over the phone what the issue was and why it should have been covered and they can fix it and reinput it in the system so they may pay it. I have BCBS also and found out that alot of the maternity care that was denied was because it was submitted incorrectly by the provider of service. So call them up and ask one of the advisors what specifically you are covered and not covered for. I just did that and was pleasantly surprised and how much they did cover.

Re: insurance vent- need advice

Call your insurance company and ask about the claim. One side might be submitting something wrong on the paperwork causing you to come up as uncovered. You may have to submit a claim directly to the ins. company. It was happening to me all the time because the ins co. had me listed at subscriber #3 instead of #2.

Re: insurance vent- need advice

i have empire BCBS (PPO) and didn't have to pay for it. call the insurance company to find out why it was denied - most likely it was because someone at the lab entered the wrong code.

Re: insurance vent- need advice

ughh i have BCBS PPO, now im scared!


im sorry you have to deal with that! they should have told you BEFOREHAND!

Re: insurance vent- need advice

call your insurance - i wouldn't be surprised if they didn't even get the bill. i went to the er last year and got a similar bill and when i called the insurance they said they had not record of the claim and to mail the bill to them. i did and they took care of it no problem.

if it turns out that the insurance really DID deny the claim, call the dr/lab and raise hell - especially if they made it seem as if the insurance would cover the fees. they can eat the cost and it really doesn't effect them, so they should be able to work with you.

Re: insurance vent- need advice

First why don't you go online and look at your EOB it should tell you WHY they denied the claim (wrong lab, not covered tests etc). This will give you an idea of who you need to talk to. They might just have to resubmit it with a different claim number.