I recently got blood work done for my annual checkup - nothing crazy, lipid panel, a1c, and CMP. Knowing my insurance provider changed (and switched to HDHP) this year, I looked up the cost and provider map on the insurance company site. It showed the local hospital where I typically get my blood work done as a good location with the total estimated cost of my blood work being like $30.
What I didn't realize at the time, was I wasn't paying nearly close enough attention and the listed hospital was actually a different hospital that is about equidistant from my home. Very dumb mistake I admit.
Under my old provider for a similar set of labs I'd typically see something like $700 billed, $580 plan discounts, $101 paid by plan, - I'd ultimately owe like $20.
Under my new plan I see 1069 billed, 532.34 provider responsibility, 536.66 allowed by benefit/my responsibility. My EOB confirms that this is an in-network provider and that they paid nothing (as expected, this is my first usage of insurance this year).
I'm still kind of new to navigating health care costs but I think the summary here is the hospital I went to doesn't offer the steep discount to my provider that the other does even though they're both "in-network". What would have been a $35 bill is $536.66 as a result. Fully out of pocket I'm sure all this would be $200 or less at an independent lab.
What talking points would you use in a situation like this? I know they offer financial assistance, but I don't think I'd qualify for that. It is the result of a dumb mistake on part for sure. But it also feels a little wrong to just pay $500 for what they typically more steeply discount for a different provider - and something that is half price or less outside their building.
I'd be a lot more willing to take my lumps on this one if it were a reasonable system where I presented my insurance card before service, they consulted their list of pricing, the discounts with this provider and offered me some rough idea of what the cost to them would be. There seems like ample opportunity to help consumers understand pricing but no incentive.
Thanks!
Submitted October 10, 2019 at 07:53PM by FirmIndependence2 https://ift.tt/2nzuGOn
