Susan in Tennessee
Well-Known Member
I have been having all kinds of fun today trying to find out what I would pay for the suggested set of pre-op/post op labs IF they are requested by my doctor and go through my insurance company, BCBS. I know the cost from Star's company but I prefer to leave no stone unturned so set out to see what I would pay with my deductible NOT being met but receiving the discounted price negotiated between BCBS and LabCorp. Star's price is really good, I think, and I really expect the discounted insurance cost to be similar to her price and I am really trying to find this out for future use more than right now as I feel sure I'll use Star's company right now. But, on down the road, since I will be going to my own doctor for other stuff, I need to know how hard I need to work on educating my doctor to get her to perhaps run tests I will need. IF the cost through her and my insurance is considerably higher than Star's company though, why even bother. So that's why I'm trying to find out these costs.
First I called LabCorp, was told by a gal there that she could give me the test code and their regular price for each test then I'd need to call my insurance company to find out what the discount was. OK. So, I got each code for each test on the sheet I had printed out along with the costs. BTW, total costs from LabCorp for these came to $2,555.00.
Next I called BCBS and explained what I was trying to do. At first BCBS woman tried to tell me there was no way to find out the discounted cost without the actual claim being submitted. I told her, look, the regular cost for the tests in question is over $2,000. I HAVE to know BEFORE I authorize my doctor to run the tests whether I'm going to be able to afford them or not! She was mediumly nice and said she understood my problem and would I wait while she checked on this further. She was gone for a long time, came back and told me the only way it "might" be possible to do this was to do some sort of "dummy claim" and for that I need all the test codes (which I already got from Labcorp this morning) and also diagnosis codes, the NPI for the lab, just as if it was actually being submitted. I got somewhat flustered at this request for the diagnosis codes and told her I would need to work on that some and get back with her. I found the NPI code for Labcorp on an old lab report so I had that and didn't realize it. I knew I had some Diagnosis codes listed on the lab request sheet I had printed out here but I also knew I needed some help to know how to match some of the DX codes up with the tests. For instance, E60 Dietary zinc deficiency code obviously would match up to the Zinc lab test, but some of the others were not nearly as apparent to me when I tried to match all up. So this is what I'm asking for help with, knowing what DX codes to put with each individual lab test. BCBS woman also was saying how some might be preventative, etc. such as in conjunction with a yearly exam. I was thinking to not use preventative codes but I really don't know, what do you think?
Wasn't sure if this post belonged in Insurance or vits and Labs, nothing is ever simple, is it?
First I called LabCorp, was told by a gal there that she could give me the test code and their regular price for each test then I'd need to call my insurance company to find out what the discount was. OK. So, I got each code for each test on the sheet I had printed out along with the costs. BTW, total costs from LabCorp for these came to $2,555.00.
Next I called BCBS and explained what I was trying to do. At first BCBS woman tried to tell me there was no way to find out the discounted cost without the actual claim being submitted. I told her, look, the regular cost for the tests in question is over $2,000. I HAVE to know BEFORE I authorize my doctor to run the tests whether I'm going to be able to afford them or not! She was mediumly nice and said she understood my problem and would I wait while she checked on this further. She was gone for a long time, came back and told me the only way it "might" be possible to do this was to do some sort of "dummy claim" and for that I need all the test codes (which I already got from Labcorp this morning) and also diagnosis codes, the NPI for the lab, just as if it was actually being submitted. I got somewhat flustered at this request for the diagnosis codes and told her I would need to work on that some and get back with her. I found the NPI code for Labcorp on an old lab report so I had that and didn't realize it. I knew I had some Diagnosis codes listed on the lab request sheet I had printed out here but I also knew I needed some help to know how to match some of the DX codes up with the tests. For instance, E60 Dietary zinc deficiency code obviously would match up to the Zinc lab test, but some of the others were not nearly as apparent to me when I tried to match all up. So this is what I'm asking for help with, knowing what DX codes to put with each individual lab test. BCBS woman also was saying how some might be preventative, etc. such as in conjunction with a yearly exam. I was thinking to not use preventative codes but I really don't know, what do you think?
Wasn't sure if this post belonged in Insurance or vits and Labs, nothing is ever simple, is it?