How is it that I owe Labcorp $ 34.94? (Part 3) – The health care blog

By Matthew Holt

For those of you who are waiting to update the Labcorp update, Blue Shield of California, Brown & Toland Physicians, the ball was moved a few years on the ground.

If you want to catch up, it’s part 1, part 2 and part 3)

You will remember that we left it with a mystery bill of $ 34.94 which did not correspond to the official amount of $ 50 that I, or the responsibility of $ 0 of the patient in my eob. I received a call from Rhia Fleming, an experienced customer representative at Labcorp, on the virtual desk of which it was dropped. We had a nice conversation in which we agreed that the co-payment should have been $ 50 or $ 0, but that it is possible that the co-payment is the lowest of $ 50 or that the Labcorp amount was trying to collect.

She had previously called the Blue Shield of California Provider line to try to understand this. Blue Shield had indeed launched this statement from Labcorp to Brown and Toland the IPA to which I am assigned to the HMO product that I bought. Labcorp costs were $ 322.28 and B&T’s response was that the contractual price (that is to say what they agreed to pay LABCORP for these tests) was $ 34.94, hence “the adjustment” of $ 287.34. However, in the Labcorp system, the algorithm interpreted the response of B&T as saying 1) The agreed payment is the $ 34.94 according to the contract and 2) they were not going to pay, so the patient must the difference. When Rhia Fleming asked the representative of Blue Shield, why the patient had the payment on this subject, the Blue Shield representative said that the procedural code and the diagnostic code of my PCP (a medical) did not count as preventive care. In other words, Labcorp has not been paid at all for having carried out these tests so far, because they are according to B&T “not preventive”. Although my Imho, CMS says they are. And of course, as it is said that my copying costs $ 0, I interpret Blue Shield of the California Eob as I say that!

Therefore, Labcorp generated the $ 34.94 bill and sent me. Who started all this telenovela.

The conclusion of BTW Rhia was that, as none of the tests was “preventive”, Labcorp invoiced me the $ 34.94 because it was the total that it was contractually due rather than the copying of $ 50 that I am supposed to pay for the laboratory work. In fact, I checked in my Labcorp account and I noticed that last year, I was in fact paid $ 50, so maybe last year, I passed different tests or in a way they changed the algorithm. I checked the EOB for this 2024 bill and the total load was $ 445.20 of which Blue Shield paid $ 28.07. No, I couldn’t find the Labcorp bill on their system, probably because I paid it! Since I paid $ 50 for the Labcorp services on this date (yes, it took me 7 months to pay!) (It is likely that the agreed payment is $ 78.07 ($ 50 + $ 28.07) which I had to make the $ 50.

Then I had another reflection.

It turns out that the results of the laboratory this year have generated another concern in the mind of my doctor. (Keep in mind that I passed the laboratory tests before visiting the office so that we can discuss the results). It seems that my iron levels are a little low, so while I was in the doctor’s office, he ordered additional tests specifically on this subject. As a medical person has technicians on site, they did my blood then and there and sent it to Labcorp.

According to my EOB, Labcorp’s fees for these new tests were $ 60.79, including Blue Shield or rather Brown and Toland paid again $ 0 and created an EOB which again said that my patient’s responsibility was $ 0. I asked Rhia to check this bill in its system and it turns out that I owe nothing to Labcorp on this set of tests. Maybe they were coded as preventive? I tried to find the invoice on my patient portal on Labcorp, but because I owe nothing, I did not receive an invoice and without an invoice number, you cannot check the invoice!

When Rhia put an end to the call with me, her next move was going to find out about Blue Shield and Brown and Tholand what was the reason for me because of $ 0 on this invoice!

Meanwhile, I await the result of the official Blue Shield survey with interest. Of course, it could have been summed up at Amazon One Medical coding the tests incorrectly. But everything is fun and games if you have unlimited patience in American health care.

And of course, it’s still not over!