how much did you pay for routine yearly well visit lab work?

[AnnieW625]

I just got a bill for my lab work that was done during my yearly well woman physical. I went to the lab requested by my doctor, which is associated with the large hospital. I got a bill today for $525!?:shrug: The total bill was $703.25, so my insurance paid $178.25. I got routine yearly cholesterol, a full thyroid panel, vitamin D levels, etc. . I was not asked to pay a co pay at the lab.

DD2 had two pee in cup tests, plus an ultra sound to rule out a UTI, and my bill for all of that is maybe $100, and all tests were performed by the same hospital.

Now I am scared that a Pap smear will cost even more?!

We have a $1000 family deductible and $20 co pays for most everything, but I have yet to have to pay more than $40 for something (DD2's portion remaining of the ultra sound) so my insurance is already paying 80% of some things it looks like. (I mean I paid $1000 for the birth of my DD1, and $200 for a full second 60 minute u/s when I was pregnant with her as well).

If the ACA is covering well visit exams wouldn't it cover lab work associated with those as well?

[tmahanes]

The first thing I would do is make sure it coded with a well visit code and not a sick/medical condition code.

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[AnnieW625]

do you know what that code is?

[tmahanes]

It just depends.... Sorry i don't :-( I would guess there is some kind of screening code as opposed to coding it with a specific condition such as diabetes or something like that. That is they way it works for colonoscopies where I work.

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[o_mom]

ACA only covers the exam and certain test, AFAIK.

As far as the deductible, prescriptions count toward that too, so if you have expensive meds, you might have met it that way.

The actual labs... a thyroid panel here bills at around $100. However, the allowed amount varies widely by lab. Our large university hospital here, which the specialists we go to use, has an allowed amount of around $80, but the smaller independent lab we use has the allowed amout as $7.xx. Really, it is more than 10 times more for me to use the lab at the doctor's office. I always ask for the order and then go to the other place. It's impossible to know ahead of time, though, which is cheaper and I only know because of trial and error.

So, point is, I could see all the stuff you had coming in at $700 allowed if I went through the hospital lab.

ETA: On the coding, unless it is something you know is covered as a well visit, it may actually be denied as not being part of a well-visit...had that happen as well.

ETA2: Did insurance actually pay the $178 or was that the write off amount? If so, it could be the $525 is the allowed amount being applied to your deductible.

[AnnieW625]

Thanks! I have not gotten an EOB yet for that lab visit, and the bill from the hospital doesn't list any CPT codes. The bill does say that the insurance paid the $178.00.

[KLD313]

I get thyroid panels done regularly and they're over $300. Idk about the other tests, though.

[SnuggleBuggles]

I don't pay anything OOP and admit to not paying attention to the EOB.

[MelissaTC]

Routine labs as part of a wellness check are covered at 100%. I am responsible for 20% (co-insurance) for diagnostic labs. My routine Pap smear would be covered at 100% as would the visit. All visits to my primary care physician are also covered at 100%. I do not have a deductible.

[roobee]

I had something similar happen to me back when I had good insurance. The clinic coded it as a visit with a doctor that wasn't in network.

It was their error - the doctor was in network. They fixed the problem and I didn't end up paying anything but I was super upset. I think I yelled (or cried) at the billing department until they hung-up on me, and then I just kept calling back until they fixed it. The bill was for over $1000, I was in my early 20's and the only reason for the visit was because I thought my BF was cheating on me so I had them run all sorts of tests.

I hope your bill is straightened out - or at least explained in a way that makes sense.

[Tondi G]

I don't know if that is correct or not as far as your insurance goes but I just went to my OB/Gyn for my annual well woman Pap. I asked that she do a swab and make sure the yeast infection I had called and was prescribed over the phone for, had cleared. when I went to the front I expected to pay for just a co-pay but was charged almost $300 for the "labs" done for the swab and my $25 co-pay for the visit. I am curious if I am going to get a bill for the Pap as well? She did say that the money would apply to my deductible but that is for nothing because my husband is now unemployed and our health insurance has run out as of this month. LOVELY! At least I got in to see my doctor .... and my pap was clean!

I hate health insurance .... every plan is different so it is so difficult to know what is going to be covered and what isn't ... what will apply to a deductible ... what is covered for a once a year well woman etc. Such BS if you ask me. There shouldn't be such variables and we shouldn't be paying as much as we do for insurance and still have to cover the difference when the charge is more than the allowable rate. what is the point? We should just try to negotiate the bill with the doctor directly and cut out the middle man.

[chozen]

I don't know if that is correct or not as far as your insurance goes but I just went to my OB/Gyn for my annual well woman Pap. I asked that she do a swab and make sure the yeast infection I had called and was prescribed over the phone for, had cleared. when I went to the front I expected to pay for just a co-pay but was charged almost $300 for the "labs" done for the swab and my $25 co-pay for the visit. I am curious if I am going to get a bill for the Pap as well? She did say that the money would apply to my deductible but that is for nothing because my husband is now unemployed and our health insurance has run out as of this month. LOVELY! At least I got in to see my doctor .... and my pap was clean!

I hate health insurance .... every plan is different so it is so difficult to know what is going to be covered and what isn't ... what will apply to a deductible ... what is covered for a once a year well woman etc. Such BS if you ask me. There shouldn't be such variables and we shouldn't be paying as much as we do for insurance and still have to cover the difference when the charge is more than the allowable rate. what is the point? We should just try to negotiate the bill with the doctor directly and cut out the middle man.

If you don't have ins. Right now you might want to mention that at your apt. They will usually charge less if your paying cash.

[ZeeBaby]

This happened to me when I went to a new dr. The dr took the blood and sent it to the wrong lab for processing. It turns out our insurance only allows processing at a specific lab. It worked out. The insurance company covered it since it was a mistake, but I am always careful to request the px and go to the correct lab.