In November 2017 my doctor ordered a skin punch test, that would need to be performed by a dermatologist. A few days before the appointment in mid-December, I called my insurance to verify that a pre-authorization had been submitted and they said it had not, but it was unneeded as the procedure was covered. When I called the doctors office to confirm the lab the sample was sent to would be in-network they panicked and said they may have to reschedule my appointment because they did not have any lab kits. The doctor’s office was actually quite nice, and over the next few days we spoke multiple times. The day of the appointment the appointment time was pushed back multiple times because they were having a kit delivered from a lab that was covered by my insurance. I asked them multiple times if it was in-network and they verified that it was. They finally called me and told me to be there in 20 minutes, and when I asked for the name of the lab the front office receptionist did not know. In January I got a noticed from my insurance that the lab was NOT in-network and that I owed the lab around 10k. I called the doctor’s office and they were shocked and once again said that the lab confirmed they were in-network. When I called the lab they had not received any notices that the procedure was denied, and said that it should have been covered. I received a letter from the lab shortly thereafter that said they knew I had no choice in where the lab was sent and they wanted to appeal on my behalf. I signed the paperwork they requested allowing them to appeal, and just received a notice from my insurance that the appeal was denied. I now owe 10k for an out of network lab . I couldn’t push the appointment back without owing a 200-dollar cancelation fee to the doctors office, and delaying the appointment would not have been possible without having the procedure done in January when my insurance max out of pocket resets. What is the best way to address this? I have heard of this happening and wanted to do everything in my power to avoid it, but it happened anyway.
Submitted March 28, 2018 at 12:41PM by hairlessmonster https://ift.tt/2Giv4Jy
