I got a down syndrome test done during the 10th week of my pregnancy. My provider seems to have referred me to an out of network lab and I was billed an amount of $3200 for the test. I went through several online blogs and seems like an upfront cash option was much cheaper, around $500. I was never told about this by my provider. What are my options here? Could I negotiate on this? Do I need to look into legal options? My insurance provider is Premera Blue Cross.
Generally it is patient responsibility to find out if the provider is out of the network or not. Have you talked to your insurance but these people are such thieves it is very difficult but just try
Yeah, I see. I did speak to my provider and she said it would be covered most likely and I might end up paying a couple hundred dollars. My bad I did not double check, but we usually end up trusting our providers. There are so many tests that keep happening during the pregnancy, so its tough to double check.
I agree. They are real cheaters. Wven if you go to emergency when you have no way who is out of network (anathesist etc) and if they are out of network you get a separate bill. The whole system is so corrupt. Anyway, talk to your provider and tell them that they referred you to the other one. See if something can be resolved
Tell Natera your doctor said it would be around X and they will likely honor it. They first tried to charge us/insurance $9600 but settled for $350.
That sounds so reassuring to hear. Thanks! Just to confirm, you mean $350 and not $3500, right? š
Yes, $350! Hope it works out for you too. Was still a bit annoyed it was more than the $200 the doctor had estimated but it was definitely worth the money (not thousands of $).
We had a dentist book in an appointment for our kid that was less than the required time from the previous appointment, so we got a bill for a few hundred dollars. Putting all the onus on patients to know this stuff, when we're basically cut out of the process, and making us spend hours on hold to get a noncommittal answer, is ridiculous. The healthcare market in the US is horribly inefficient and corrupt. A well run system could fire half the administrators, probably more. They don't add anything except bureaucracy.
Very well put, could not agree more.
Is this Natera one?
Yes, this is from Natera
Natera is notorious for billing insane amounts. It charged us around $10K even though Natera was in-network for my insurance but insurance figured some tests were unnecessary which my doctor checked on the form. After some back and forth, Natera told us to pay $500 and finish matter but since Natera was in-network for me, I opened a complaint about Natera and my insurance team did investigation on COE and determined Iām not liable for any dollar. My insurance sent notice to Natera and they closed the case with 0$ due from patient. So relax :)