Update: Just got over $10K bill for out-of-network lab testing!!!!!

I am pregnant and recently went to my (in-network) obgyn for a routine visit. During the visit (and because I'm over 35 years old) they drew blood for NIPS testing (Non Invasive Prenatal Screening) and sent it to an out-of-network lab for processing (we had no idea it was going out-of-network).

We got billed over $10K for this testing!!! I nearly passed out when I found out. Because this lab is out-of-network, my insurance plan will only cover $300 towards the bill. This has bumped our out-of-pocket maximum from $6K (for in-network) to over $8K now because there is out-of-network billing involved. I'm so distraught over this and as a pregnant lady this is the last thing I needed to hear right now.

Is there anything I can do to fight this??? Has anyone been through this before? Please feel free to FM advice and thanks for letting me vent!




*****
Update: Ok so contacted the lab and Blackjack is right! They bill these ridiculous amounts to get the insurance companies to pay up and then write off the rest. The patient is responsible for $100 copay. I really wish this was told to me before I saw the initial bill and had a heart attack though!!! That can't be good for baby! So FYI for anyone who gets this kind of lab testing just call them directly before you pass out lol.

Thanks to everyone who replied!

Message edited 5/13/2015 4:06:11 PM.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

This is not your fault. Your ob's office made a mistake and sent it to the wrong lab (an out of network lab). You should not be held responsible. I would call your OB billing office in the morning.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Just got over $10K bill for out-of-network lab testing!!!!!

You might have luck with the lab knocking the price down. Does the test have a name like Panorama? 10k sounds a lot, even for those tests...

Message edited 5/11/2015 8:55:22 PM.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Re: Just got over $10K bill for out-of-network lab testing!!!!!

If this is the early genetics test that they do then I thought more like $500 out of pocket. I would fight this tooth and nail. So unfair.

Just got over $10K bill for out-of-network lab testing!!!!!

If it is a case of blood being sent to the wrong lab, I think you will be able to fight it. I will tell you that my in network lab bill for my first DD was around $1500 because I have a high deductible.
For tests like Panorama and MaterniT21, people sometimes get patient assistance from the testing company.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Just got over $10K bill for out-of-network lab testing!!!!!

This happened to me but it was when I was doing fertility testing. It was an out of network test. My doctor told me it would be $800 tops and I said okay. Then I get a 17k bill! I almost DIED. My doctor made the mistake and was upfront with insurance but somehow I had to pay $2,500 over a 6mos period (they out me on a payment plan) it was really hard because I had already spent thousands and thousands to get pregnant and I was so mad.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

The lab is called Progenity Genetic Testing... Verifi/Progenity... if anyone has had experience with them.

I was tested at almost 12 weeks and the test screens for Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18), Patau syndrome (Trisomy 13) and some other abnormalities (though I don't know if I was screened for those or just the main ones) and was also able to determine the baby's sex.

Message edited 5/11/2015 9:46:01 PM.

Just got over $10K bill for out-of-network lab testing!!!!!

I would call the lab and see if they can work anything out with you. Often they will knock it down to a few hundred (so I've heard) or maybe even take the few hundred the insurance company paid.

We recently went through the NIPS testing and the labs said that they bill the insurance company the "full amount" but then will send you a bill for a few hundred. I called all the labs offered BEFORE we had the blood drawn. Most of the labs were OON for our insurance.

One of the companies said that they "write off" a lot of the testing costs since they are playing the long game to get these tests approved and negotate a rate with the insurance companies for more $$$ later. (the more $$$ later is my sense. They said they want to "offer the test to more patietns, etc, etc"

Good luck!

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Message edited 5/11/2015 10:45:52 PM.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

When was the testing? There is a new law about surprise bills... Went into effect April 1..

Surprise Bill Law

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Call your OB tomorrow and tell them that because of this you are going to find another OB. That is ridiculous and their administrative staff needs to be held responsible. I am sure they will knock it down but you shouldn't have to pay any more than what you would have paid if they sent it to the right, in network lab or told you the price beforehand. Worst case I think that your OB will eat the bill before losing you as a patient.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Call your insurance provider. Sometimes they have provisions in the policy that allow for payments to be made to out of network providers as if they were in network when it's not YOUR decision to use that provider. There are some protections in place for patients who have no choice as to who was used and can not be punished. You didn't voluntarily go to LabCorp knowing it was an out of network provider when you should have gone to Quest. This was totally out of your hands.

You can also ask your OB office for a copy of the consents that you have signed. If you were in no way informed that the specimen would be sent to an out of network lab and/or of the potential expense involved, you certainly have an argument with your OB office there. They didn't give you a fair opportunity to explore your other options.

Lastly, as PP have said, you can call the lab and they will usually negotiate the bill down to what they will get from an insurance company for payment which is significantly less.

Message edited 5/12/2015 7:12:27 AM.

Just got over $10K bill for out-of-network lab testing!!!!!

I had something similar happen to me--not during pregnancy but for anther gyn issue-- my doctor's office sent my samples to an out of network lab and they took responsibility for the bill. The in network lab was written on the top of my chart.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

That's an outrageous amount!

I was told this lab test would cost me a few hundred even if my insurance provider won't pay for it - definitely nowhere near 17k!

There's alot of threads out there about outrageous Progenity Testing bills. Definitely fight tooth and nail over it. Have the OB call the lab directly on your behalf and ask the OB to tell them you need the tests due to your age and risk of other forms of invasive testing like CVS. Since the OB's office made the mistake and they provide alot of business to this lab, they should be willing to lower the price to several hundred.

Here's one thread:
http://community.babycenter.com/post/a48952531/genetic_testing_not_covered_by_insurance

Good luck!

Message edited 5/11/2015 11:38:04 PM.

Just got over $10K bill for out-of-network lab testing!!!!!

I actually had this happen to me except it was for blood work drawn for a physical. Bill was $8K!! I almost passed out when i got it. I called my drs office right away and emailed a picture of the bill. They resubmitted the info to the lab and i never had to pay anything. It did take me about three months to get everything settled though. Also, i called the lab just to let them know i wasnt going to be paying this amount and they were the ones who directed me back to the drs office.

Just got over $10K bill for out-of-network lab testing!!!!!

Btw- i was told that genetic testing was covered as of 2015- i made sure to ask and they said this was just recently approved...

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Call your OB and tell them you should not be held responsible because they sent the bloodwork to an OON lab. If all else fails then see if the lab will work something out with you. They may let you pay a "reduced" rate.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

That is insane! I would call your ob's office & speak to the office mgr. Tell them that you really need their help fighting this bill & that you are so upset over this & dh is considering changing practices (blame DH..lol) For them to say sorry we didn't notify you that it was going to cost so much is not good enough. We are taking about $10k not $100 here.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Deep breath. Same thing happened to me with this test. Though I had gone to a genetics counselor, not my OB, and my bill was closer to $13k!

Regardless, I just called my insurance company and told them that my in-network OB sent me for this test and they ran it through a second time as in-network. I only had to pay my $40 copay. Start by calling your insurance company and calmly explain the situation.

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Re: Just got over $10K bill for out-of-network lab testing!!!!!

Call your HR person. Make them aware of the situation. They should be able to cut through all this red tape BS for you. I would also most certainly call the doctor back. Their response is not acceptable. They should have been upfront with you about the cost. If they don't cooperate I would be reaching out to News 12 or some other station.