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x-post: Update: I got billed over $10K for NIPS testing at out of network lab!!!!

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Mago
LIF Infant

Member since 5/14

233 total posts

Name:

x-post: Update: I got billed over $10K for NIPS testing at out of network lab!!!!

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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.

It was billed as CYTOGENETICS DNA PROBE. 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.

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 found out 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 4:03:39 PM.

Posted 5/12/15 12:05 AM
 
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PrayingForBaby747
LIF Adolescent

Member since 6/13

592 total posts

Name:
C

Re: x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

This is completely horrible and I'm so sorry that you had to deal with this. What insurance do you have? I have NYSHIP and had gotten a ton of bloodwork done months ago by my out-of-network provider and ended up with a bill of $10,450! I nearly crapped myself so I know that feeling. However I called the doctors office and spoke to whoever handled their billing and it ended up that they used the wrong codes for the insurance. This might not be your case but either way I would talk to your doctors office and see if they can help. Do you have out of network coverage with your insurance?

Posted 5/12/15 9:38 AM
 

SummerMom
Now a mom of 2!

Member since 6/07

4970 total posts

Name:

Re: x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

Something similar happened to me. I'm over 35 and have a history of losses with a genetic factor, so my OB said the test would be free for me (a different brand, though - MaterniT-21).

Well, 8 weeks later I got a bill in the mail for almost $3000! Turns out my insurance company stopped paying for the testing. My doctor hadn't known. His office told me that I need to call the 1-800 number on the bill and claim "financial hardship" and they'd knock the bill down to $200. That's exactly what happened. It was a 2 minute phone call. Now, $200 isn't nothing, but it's a heck of a lot better than $3000.

Try calling the company and telling them what happened. If it's anything like my situation, they hear the story 100 times a day and have a protocol in place. Good luck!

Posted 5/12/15 9:52 AM
 

tryin4baby3
LIF Toddler

Member since 8/12

425 total posts

Name:

x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

Ask your ob if they have a representative who handles that servicer provider. If so, call that person and they will most likely work something out. If not, call the company directly and see what they will work out. I've gotten bills for similar testing twice (not for 10k, but for more than I was willing to spend) and each time owed nothing despite the bill. If your insurance only paid $300, I would think you will owe some, but not even close tob10k.

Posted 5/12/15 9:54 AM
 

nycgirl
Angels!

Member since 3/09

7721 total posts

Name:

Re: x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

Posted by SummerMom

Something similar happened to me. I'm over 35 and have a history of losses with a genetic factor, so my OB said the test would be free for me (a different brand, though - MaterniT-21).

Well, 8 weeks later I got a bill in the mail for almost $3000! Turns out my insurance company stopped paying for the testing. My doctor hadn't known. His office told me that I need to call the 1-800 number on the bill and claim "financial hardship" and they'd knock the bill down to $200. That's exactly what happened. It was a 2 minute phone call. Now, $200 isn't nothing, but it's a heck of a lot better than $3000.

Try calling the company and telling them what happened. If it's anything like my situation, they hear the story 100 times a day and have a protocol in place. Good luck!



I agree 100% with this. Call them.

Posted 5/12/15 10:01 AM
 

pinkiegirl

Member since 7/07

2160 total posts

Name:
Dana

Re: x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

I havent gotten my bill yet... but I got my explanation of benefits and same thing.. Bill was for 2400!!
Ridiculous!!!

Posted 5/12/15 11:28 AM
 

Alexandra17
Keep It Positive

Member since 4/09

6262 total posts

Name:
Alexandra (ali)

x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

I have to say, this scares me because as I was reading your first post, I had just signed in at Quest for the initial bloodwork but it was all routine and I don't think anything new. I will always ask to double check now, that is a big fear, getting these bills!

Posted 5/12/15 8:38 PM
 

LoveBug302
Baby Girl #2 is Here!

Member since 7/11

1652 total posts

Name:

Re: x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

Posted by SummerMom

Something similar happened to me. I'm over 35 and have a history of losses with a genetic factor, so my OB said the test would be free for me (a different brand, though - MaterniT-21).

Well, 8 weeks later I got a bill in the mail for almost $3000! Turns out my insurance company stopped paying for the testing. My doctor hadn't known. His office told me that I need to call the 1-800 number on the bill and claim "financial hardship" and they'd knock the bill down to $200. That's exactly what happened. It was a 2 minute phone call. Now, $200 isn't nothing, but it's a heck of a lot better than $3000.

Try calling the company and telling them what happened. If it's anything like my situation, they hear the story 100 times a day and have a protocol in place. Good luck!





same thing happening with me right now, they did an emergency maternity21 test at 20w because of some things they saw at my anatomy scan that they didn't like. I also had am amnio and some other tests. I got a bill for the maternity21 for $2700. my nurse gave me the reps # for the lab that was used. i called and she said it will most likely get knocked down to $200 or less. that's still a lot of money that I don't have, but it will be easier to pay off that $2700!! Keep calling your doc and insurance company. I hope it gets resolved for u!

Posted 5/13/15 11:48 AM
 

Tinyswife
My family is complete

Member since 4/07

1819 total posts

Name:
Cathleen

Re: x-post: I got billed over $10K for NIPS testing at out of network lab!!!!

I phoned the company and they only asked me to pay $200 out of the $1,500 bill that I got. The rest was covered by my deductible.

Posted 5/13/15 2:59 PM
 

Mago
LIF Infant

Member since 5/14

233 total posts

Name:

Re: x-post: Update: I got billed over $10K for NIPS testing at out of network lab!!!!

Update in original post.

*****
Update: Ok so contacted the lab and found out 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!

Posted 5/13/15 4:07 PM
 

BabyToo
LIF Zygote

Member since 5/15

39 total posts

Name:

x-post: Update: I got billed over $10K for NIPS testing at out of network lab!!!!

So glad to hear this was sorted out. When I read this I was so horrified and upset for you.

Posted 5/14/15 9:55 AM
 
 

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Topic Posted By Started Replies Forum
Update: Just got over $10K bill for out-of-network lab testing!!!!! Mago 5/11/15 27 Families Helping Families ™
 
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